Individual
LEONARD TRENT WONNENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
172 4TH ST SE, HURON, SD 57350-2510
(605) 353-6200
(605) 353-6300
Mailing address
172 4TH ST SE, HURON, SD 57350-2590
(605) 353-6200
(605) 353-6300
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0803
SD
Other
Enumeration date
01/25/2012
Last updated
01/08/2025
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