Moses Nguu Ikiugu, OTR

Individual provider Active NPI Occupational Therapist · Vermillion, SD

NPI 1053604272 · NPPES record last updated May 20, 2011

Key facts

NPI
1053604272
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
0644 (SD)
Practice address
16 E Bloomingdale St
Vermillion, SD 57069-3071
Phone
(605) 624-9352
NPI assigned
May 20, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0644 SD Yes

Addresses

Primary practice location

16 E Bloomingdale St
Vermillion, SD 57069-3071

Mailing address

16 E Bloomingdale St
Vermillion, SD 57069-3071
Phone (605) 624-9352

Other providers in Vermillion, SD

All providers in Vermillion, SD · Occupational Therapist in South Dakota

Sources for this page

Verify at the official NPI Registry.