Organization
DESTINY HEALTHCARE INTERNATIONAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN K KIDMAN M.D. (EXECUTIVE DIRECTOR)
(605) 339-3378
Entity
Organization
Contact information
Practice address
1417 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1715
(605) 339-3378
(605) 339-0710
Mailing address
1417 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1715
(605) 339-3378
(605) 339-0710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1799
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5604647
—
SD
05
—
6701870
—
SD
Enumeration date
07/18/2006
Last updated
03/17/2018
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