Organization
WYATT NASH-KELLER OD PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WYATT NASH-KELLER O.D. (OPTOMETRIST)
(605) 370-6066
Entity
Organization
Contact information
Practice address
960 22ND AVE S, BROOKINGS, SD 57006-2830
(605) 370-6066
Mailing address
960 22ND AVE S, BROOKINGS, SD 57006-2830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
723
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124371992
—
SD
Enumeration date
02/16/2016
Last updated
02/16/2016
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