Organization
KATHLEEN VAN DE WALLE DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN VAN DE WALLE D.O. (PRESIDENT)
(605) 229-3682
Entity
Organization
Contact information
Practice address
1314 N MAIN ST, ABERDEEN, SD 57401-2032
(605) 229-3682
Mailing address
1314 N MAIN ST, ABERDEEN, SD 57401-2032
(605) 229-3682
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0248
SD
Other
Enumeration date
01/15/2007
Last updated
08/22/2020
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