Individual
DR. KATHRYN OPBROEK HAIVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1710 NORTH AVE, SPEARFISH, SD 57783
(605) 642-8480
(605) 642-8185
Mailing address
1710 NORTH AVE, SPEARFISH, SD 57783
(605) 642-8480
(605) 642-8185
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
502
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119816500
EQUALITY CARE
WY
01
—
4995272
BLUE CROSS
SD
05
—
9202840
—
SD
Enumeration date
08/11/2006
Last updated
09/17/2012
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