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Individual

TAMMI K STANGOHR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1500 W 22ND ST, STE 102, SIOUX FALLS, SD 57105-1503
(605) 328-7700
(605) 328-7775
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0564
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6825410
SD
Enumeration date
06/27/2005
Last updated
11/20/2019
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