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Search › South Dakota › 2081S0010X

Jackson Diede, MAT, ATC

NPI 1760054373 · on the registry since 2021

Practice

Address
810 E 23rd St
Sioux Falls, SD 57105
Phone
(605) 331-5890
Organisation at this address
Manus, Llc
Avera Mckennan
Avera Mckennan
Inferred from a shared address, not stated in the registry.
Clinicians at this address
119

Registry record

Primary taxonomy
2081S0010X
2081S0010X
Licence states on file
SD
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-07-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Dakota