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Individual

JONNI A ROUSSEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
317 MAIN STREET, EAGLE BUTTE, SD 57625-0000
(605) 964-2814
Mailing address
317 MAIN STREET, EAGLE BUTTE, SD 57625-0000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R031469
SD

Other

Enumeration date
07/06/2009
Last updated
07/06/2009
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