Individual
DEBRA J GAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 3RD AVE NW, WATERTOWN, SD 57201-2410
(605) 303-4033
Mailing address
17 3RD AVE NW, WATERTOWN, SD 57201-2410
(605) 303-4033
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
00204225
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00204225
DRIVERS LICENSE
SD
Enumeration date
10/27/2022
Last updated
10/27/2022
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