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Individual

LOREN T VILHAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
701 8TH AVE NW, ABERDEEN, SD 57401-1865
(605) 226-2663
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2867

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0580
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1254560001
CIGNA MEDICARE
SD
05
6827400
SD
01
P00272729
MEDICARE RAILROAD PTAN
Enumeration date
01/19/2006
Last updated
12/23/2013
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