Provider Demographics
NPI:1477740199
Name:REMILLARD, P.C.
Entity type:Organization
Organization Name:REMILLARD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:REMILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-258-5058
Mailing Address - Street 1:1122 WEST DIVIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-0212
Mailing Address - Country:US
Mailing Address - Phone:701-258-5058
Mailing Address - Fax:701-258-1041
Practice Address - Street 1:1122 W DIVIDE AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1202
Practice Address - Country:US
Practice Address - Phone:701-258-5058
Practice Address - Fax:701-258-1041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13407Medicaid
ND25373OtherBCBS
ND13407Medicaid
ND25373OtherBCBS