NPI 1003658527

Autumn Vasichek, BMOD

Practitioner Specialist Grand Forks, ND

Practice location

Address: 151 S 4th St STE 401, Grand Forks, ND 58201-4715
Phone: (701) 795-3000

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1003658527
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Jun 2024
Record last updated: 15 May 2026

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.