Individual
MR. RONALD THOMAS WREN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
1010 W 1ST ST, REDFIELD, SD 57469-1506
(605) 472-0510
(605) 472-0331
Mailing address
PO BOX 590, REDFIELD, SD 57469-0590
(605) 472-0510
(605) 472-0331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0621
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6822970
—
SD
Enumeration date
07/27/2006
Last updated
06/08/2010
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