Individual
STEWART P. BOFENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-A
Contact information
Practice address
1310 W 22ND ST, SIOUX FALLS, SD 57105-1501
(605) 328-8200
(605) 328-8201
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
5
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5832902
—
SD
Enumeration date
06/15/2005
Last updated
05/08/2008
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