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Organization
SIOUX OPTICAL
Active
Organization
SIOUX OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS C WHITE MD (GENERAL PARTNER)
(605) 334-7725
Entity
Organization
Contact information
Practice address
1701 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1721
(605) 334-7725
(605) 334-8247
Mailing address
1701 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1721
(605) 334-7725
(605) 334-8247
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
NONE REQUIRED
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077392
WELLMARK FEDERAL EMPLOYEE
SD
05
—
9280230
—
SD
Enumeration date
07/01/2005
Last updated
04/20/2008
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