Provider Demographics
NPI:1477737625
Name:PAT SITZER
Entity Type:Organization
Organization Name:PAT SITZER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-2810
Mailing Address - Street 1:751 1ST ST.
Mailing Address - Street 2:PAT SIZER
Mailing Address - City:MINTO
Mailing Address - State:ND
Mailing Address - Zip Code:58261
Mailing Address - Country:US
Mailing Address - Phone:701-360-0056
Mailing Address - Fax:
Practice Address - Street 1:751 1ST ST.
Practice Address - Street 2:PAT SIZER
Practice Address - City:MINTO
Practice Address - State:ND
Practice Address - Zip Code:58261
Practice Address - Country:US
Practice Address - Phone:701-360-0056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1034314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1034OtherND BOARD OF PHYSL THERAPY