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Individual

MASON WELLSKOPF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1420 N 10TH ST, SPEARFISH, SD 57783-1532
(605) 717-8595
Mailing address
918 SAINT JOE ST, SPEARFISH, SD 57783-1729
(715) 450-5025

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0742
SD

Other

Enumeration date
11/09/2020
Last updated
11/09/2020
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