| NPI | 1013668698 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP ADDICTION MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM FLICEK President/CEO 605-322-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |