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Individual

RENAE TRUDAEU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1905 W 57TH ST ST 3, SIOUX FALLS, SD 57108
(605) 371-3533
(605) 371-3533
Mailing address
1905 W 57TH ST ST 3, SIOUX FALLS, SD 57108
(605) 371-3533

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT11046
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11046
NON MEDICARE PROVIDER
SD
Enumeration date
12/15/2020
Last updated
12/16/2020
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