# AVERA ST. LUKE'S

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Physical Medicine Aberdeen
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093759177
- **Authorized official:** TESS MOELLER (VP)
- **Authorized official phone:** (605) 622-2807

## Contact information

- **Practice address:** 201 S LLOYD ST, SUITE E202, ABERDEEN, SD 57401-4552
- **Practice address phone:** (605) 622-2898
- **Practice address fax:** (605) 622-2897
- **Mailing address:** PO BOX 1460, ABERDEEN, SD 57402-1460
- **Mailing address phone:** (605) 622-2898
- **Mailing address fax:** (605) 622-2897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 10525 | SD | Yes |

## Other

- **Enumeration date:** 06/16/2006
- **Last updated:** 07/15/2022