Individual
JON VANDER MATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 MAC LANE, PIERRE, SD 57501-0758
(605) 224-5901
(605) 945-9295
Mailing address
100 MAC LANE, PIERRE, SD 57501-0758
(605) 224-5901
(605) 945-9295
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0052
SD
Other
Enumeration date
06/16/2006
Last updated
02/12/2008
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