Individual
BETH AMDAHL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1310 W 22ND ST, SIOUX FALLS, SD 57105-1501
(605) 782-2000
(605) 782-2721
Mailing address
1310 W 22ND ST, SIOUX FALLS, SD 57105-1501
(605) 782-2000
(605) 782-2721
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0217
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1151472
—
IA
05
—
6820278
—
SD
Enumeration date
09/02/2005
Last updated
07/08/2007
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