Individual
MARK STRUBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
121 S MAIN AVE, WAGNER, SD 57380
(605) 384-3565
Mailing address
310 8TH AVE NW STE 503, ABERDEEN, SD 57401-2369
(605) 225-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
582
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9202017
—
SD
Enumeration date
07/24/2006
Last updated
11/30/2007
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