NPI | 1003585548 |
---|---|
Doing Business As | AVERA MEDICAL GROUP WILLCOCKSON EYE ASSOCIATES |
Entity Type | Organization |
Authorized Contact | DOUGLAS W EKEREN President/CEO 605-668-8322 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 152W00000X Optometrist |
Enumeration Date | 2021-09-08 |
Last Update Date | 2025-01-07 |