Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 16448 | ND |
NPI | 1013143346 |
---|---|
Provider Name | Dr. Jason Bennett Coombs |
First Address | Minot, ND 58702-5010 |
Second Address | Minot, ND 58701-6905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2009 |
Last Update Date | 28/07/2021 |