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General NPI Number Information
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NPI Number | 1679421143
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Entity Type | Individual
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Provider Name | ALEXANDER BRADEN LAUSENG
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Gender | Male
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 2501 W 22ND ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1305
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Country | US
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Telephone | 605-336-3230
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Fax |
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Provider Business Mailing Address
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Address Line | 3429 S MOONFLOWER AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57110-4421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | R044720
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License Number State | SD
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