Individual
SUSAN MARIE MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
511 S NEBRASKA ST, SALEM, SD 57058-8917
(605) 425-3303
(605) 425-3306
Mailing address
411 SE 10TH ST STE 103, MADISON, SD 57042-3571
(605) 556-0175
(605) 556-0162
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0428
SD
Other
Enumeration date
07/25/2018
Last updated
10/04/2018
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