Individual
MR. WAYNE LEE KUDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 W 16TH AVE, TYNDALL, SD 57066-2318
(605) 589-3341
Mailing address
2922 ADKINS DR, YANKTON, SD 57078-5307
(605) 665-1193
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
111
SD
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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