| Total Transformation Clinic, Pc | |
|
317 16th St Nw Minot ND 58703-2919 | |
| (701) 837-9900 | |
| Not Available |
| Full Name | Total Transformation Clinic, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 317 16th St Nw, Minot, North Dakota |
| Authorized Official Name and Position | Felistas Madziwa (PHYSICIAN) |
| Authorized Official Contact | 7015003027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Transformation Clinic, Pc 317 16th St Nw Minot ND 58703-2919 Ph: (701) 837-9900 | Total Transformation Clinic, Pc 317 16th St Nw Minot ND 58703-2919 Ph: (701) 837-9900 |
| NPI Number | 1376963520 |
|---|---|
| Provider Enumeration Date | 04/25/2014 |
| Last Update Date | 06/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376963520 | NPI | - | NPPES |
| 1124006879 | Other | ND | NPI |
| 10461 | Other | ND | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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