(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003536426
Provider Name: CONNIE IDLAND
Entity Type: Individual
Taxonomy Code: 3747P1801X
Specialty: Technician
License Number:
Most Important Dates
Enumeration Date: 08/29/2022
Last Updated: 08/29/2022
Provider Practice Location
502 1ST ST
TRENTON
ND
588534052
Practice Location Phone/Fax
Phone: 4069742294
Fax:
Provider Mailing Location
PO BOX 725
WILLISTON
ND
588020725
Provider Mailing Phone/Fax
Phone: 4069742294
Fax: