DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. NATHAN HENRY WIEDERHOLT, O.D.

Active Sole Proprietor

Optometrist · CUSTER, SD

Registration Details

NPI Number
1447414461
Provider Type
Individual
Gender
Male
NPI Issued
Jul 18, 2008 (17.794846927909 yrs)
Last Updated
Jun 16, 2010
License
656 (SD)
Sole Proprietor
Yes

Practice Information

Address
322 MOUNT RUSHMORE RD
SUITE 120
CUSTER, SD, 577301936
Browse SD providers · Browse ZIP 57730
Phone
6056732716
Fax
6056732017
Primary Specialty
Optometrist
152W00000X

Other Optometrist Providers in CUSTER, SD

Name Credential NPI
VERNON WONG OD 1245360510
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.