Individual
COURTNEY MOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6215 S CLIFF AVE, SIOUX FALLS, SD 57108-8596
(605) 322-3300
Mailing address
1200 S 7TH AVE, SIOUX FALLS, SD 57105-0900
(605) 504-5400
(605) 504-5150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5728
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5611792
—
SD
Enumeration date
06/20/2006
Last updated
04/19/2022
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