| Doctor Name: | COLETTE BYRUM |
| NPI Number: | 1861676728 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSRT(R)(M) |
| License Number: | |
| Business Practice Address: | 3883 74th Ave Ne Fort Totten, ND - 583350309 |
| Business Phone Number: | 7017661629 |
| Business Fax Number: | |
| Mailing Address: | Po Box 309, FORT TOTTEN |
| State: | ND |
| Postal Code: | 583350309 |
| Phone Number: | 7017661600 |
| Fax Number: | |
| NPI Enumeration Date: | 12/27/2007 |
| NPI Last Update Date: | 12/27/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3402X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Radiography |
| Taxonomy Definition: | |