Provider Demographics
NPI:1043620677
Name:GANGE, KARA (PHD, ATC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:GANGE
Suffix:
Gender:F
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CENTENNIAL BLVD N
Mailing Address - Street 2:HNES DEPT 2620
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6050
Mailing Address - Country:US
Mailing Address - Phone:701-231-5777
Mailing Address - Fax:701-231-8872
Practice Address - Street 1:1301 CENTENNIAL BLVD N
Practice Address - Street 2:HNES DEPT 2620
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58108-6050
Practice Address - Country:US
Practice Address - Phone:701-231-5777
Practice Address - Fax:701-231-8872
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND294-042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer