Provider Demographics
NPI:1134445794
Name:MIDWEST HYPNOSIS CLINICS/NWCC
Entity type:Organization
Organization Name:MIDWEST HYPNOSIS CLINICS/NWCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DCH
Authorized Official - Phone:701-280-2672
Mailing Address - Street 1:PO BOX 10025
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58106-0025
Mailing Address - Country:US
Mailing Address - Phone:701-280-2672
Mailing Address - Fax:
Practice Address - Street 1:118 BROADWAY N
Practice Address - Street 2:SUITE 205
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-4950
Practice Address - Country:US
Practice Address - Phone:701-280-2672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center