Individual
KYLE RANDALL BRUSCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 312-2200
(605) 312-2222
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
CP001633
SD
363L00000X
Nurse Practitioner
Primary
A166919
IA
Other
Enumeration date
09/06/2019
Last updated
04/28/2022
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