Individual
DR. ASHLEY M GENTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
106 W 69TH ST, SIOUX FALLS, SD 57108-6417
(605) 274-6717
(605) 275-4804
Mailing address
6201 S. MINNESOTE AVE, SIOUX FALLS, SD 57108-2559
(605) 274-6717
(605) 275-4804
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1941DT
KY
152W00000X
Optometrist
Primary
712
SD
152WV0400X
Vision Therapy Optometrist
1941DT
KY
152WV0400X
Vision Therapy Optometrist
712
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9204450
—
SD
05
—
9204452
—
SD
Enumeration date
08/13/2013
Last updated
05/20/2019
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