Individual
JAMIE J LIUDAHL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 MAC LANE, PIERRE, SD 57501-0758
(605) 224-5901
(605) 945-5296
Mailing address
100 MAC LANE, PIERRE, SD 57501-0758
(605) 224-5901
(605) 945-5296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5660
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5608410
—
SD
Enumeration date
05/30/2006
Last updated
07/08/2007
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