Individual
LEE V GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6 N ROOSEVELT ST, ABERDEEN, SD 57401-3348
(605) 725-9900
(605) 725-9902
Mailing address
6 N ROOSEVELT ST, ABERDEEN, SD 57401-3348
(605) 725-9900
(605) 725-9902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0435
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0435
DAKOTA CARE
SD
01
—
4994784
BCBS
—
01
—
5830333
PALMETTO GBA MEDICARE
SD
05
—
5830333
—
SD
Enumeration date
12/20/2006
Last updated
12/10/2007
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