| NPI | 1003889122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS LIEDTKE Physician 605-720-1389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: SD 2411) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-22 |