NPI 1003574971

Jaxon Bergum

Practitioner Other Technician Grand Forks, ND

Practice location

Address: 930 N 3rd St, Grand Forks, ND 58203-2408
Phone: (701) 795-9143

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence 10586

Other Technician, Other providers in North Dakota →

Registry record

NPI: 1003574971
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Dec 2021
Record last updated: 7 Dec 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.