BLUE WATER THERAPY LLC NPI 1245475797

NPI Information

NPI: 1245475797
Provider Name: BLUE WATER THERAPY, LLC
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
3321 4TH AVE S STE D
FARGO, ND
ZIP 58103
Phone: (701) 200-8181
Get Directions

BLUE WATER THERAPY, LLC is a rehabilitation clinic center in Fargo, ND. BLUE WATER THERAPY, LLC NPI is 1245475797. The provider is registered as an organization entity type.

The provider's business location address is:

3321 4TH AVE S STE D
FARGO, ND
ZIP 58103-235
Phone: (701) 200-8181

The provider's authorized official is Gabriel Thomas Evenson .
The authorized official title is President and has the following contact phone number (701) 200-8181.

The enumeration date for this NPI number is 12/12/2008 and was last updated on 12/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	995	NORTH DAKOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »