Individual
DR. TERRY J WOLTHUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1230 NORTH AVENUE SUITE 3, SPEARFISH, SD 57783-1572
(605) 642-4656
(605) 717-2413
Mailing address
1230 NORTH AVENUE SUITE 3, SPEARFISH, SD 57783-1572
(605) 642-4656
(605) 717-2413
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
567
SD
152W00000X
Optometrist
T567
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9203223
—
SD
Enumeration date
06/10/2006
Last updated
04/14/2022
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