Individual
AMON EUSTACHE ABOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 N MINNESOTA AVE STE 101, SIOUX FALLS, SD 57104-2463
(605) 335-0023
Mailing address
411 N MINNESOTA AVE STE 101, SIOUX FALLS, SD 57104-2463
(605) 335-0023
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-0838542
—
SD
Enumeration date
04/25/2017
Last updated
04/25/2017
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