NPI 1134838428

Brandon Matthew Horse Looking

Practitioner Driver Bismarck, ND

Practice location

Address: 2403 E Thayer Ave, Bismarck, ND 58501-5014
Phone: (701) 202-7731
Mailing address: 1119 University Dr Lot 1508, Bismarck, ND 58504-6614

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence HOR000655 (ND)

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Registry record

NPI: 1134838428
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Nov 2022
Record last updated: 16 Nov 2022

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.