NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1427788504
IMDIEKE
SAMANTHA
2401 DEMERS AVE
GRAND FORKS
ND
582014183
1275126617
SMITH
TERESA
ANN
2401 DEMERS AVE
GRAND FORKS
ND
58201
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