Individual
CHRISTIAN DEJONGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
302 N HARTH AVE, MADISON, SD 57042-2219
(605) 256-6911
Mailing address
PO BOX 324, HOWARD, SD 57349-0324
(712) 470-5843
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
780
SD
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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