Individual
KATHLEEN IONE RED DOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 MAIN ST, EAGLE BUTTE, SD 57625
(605) 964-3007
(605) 964-1156
Mailing address
PO BOX 1012, EAGLE BUTTE, SD 57625-1012
(605) 964-3007
(605) 964-1156
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R039790
SD
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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