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Individual

CHELSEA DEITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1300 OAK ST, FAULKTON, SD 57438-2149
(605) 598-6262
Mailing address
35147 163RD ST, FAULKTON, SD 57438-6710

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1747
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5306900
SD
Enumeration date
07/09/2014
Last updated
07/09/2014
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