Provider Demographics
NPI:1629253018
Name:KUMMROW, BELINDA JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:BELINDA
Middle Name:JANE
Last Name:KUMMROW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BELINDA
Other - Middle Name:JANE
Other - Last Name:HAUGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1555 43RD ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3314
Mailing Address - Country:US
Mailing Address - Phone:701-356-6700
Mailing Address - Fax:
Practice Address - Street 1:1555 43RD ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3314
Practice Address - Country:US
Practice Address - Phone:701-356-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5054111N00000X
ND868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor