Wyatt Nash-Keller, O.D.
Optometrist in Brookings, SD. Individual provider (NPI-1).
NPI number1124371992
StatusActive
Last updated in NPPESJun 24, 2020
Details
- NPI
- 1124371992
- Entity type
- Individual (NPI-1)
- Name
- Wyatt Nash-Keller
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 18, 2012
- Certification date
- Jun 24, 2020
- Last updated
- Jun 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 723 | SD | Yes |
Practice location
1208 22nd Ave SBrookings, SD 57006-2804
Phone 605-692-2020 · Fax 605-692-9594
Mailing address
1208 22nd Ave SBrookings, SD 57006-0284
Phone 605-692-2020 · Fax 605-692-9594
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