# KATHLEEN VAN DE WALLE DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295886307
- **Authorized official:** DR. KATHLEEN VAN DE WALLE D.O. (PRESIDENT)
- **Authorized official phone:** (605) 229-3682

## Contact information

- **Practice address:** 1314 N MAIN ST, ABERDEEN, SD 57401-2032
- **Practice address phone:** (605) 229-3682
- **Mailing address:** 1314 N MAIN ST, ABERDEEN, SD 57401-2032
- **Mailing address phone:** (605) 229-3682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0248 | SD | Yes |

## Other

- **Enumeration date:** 01/15/2007
- **Last updated:** 08/22/2020