| NPI | 1043596703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BATY Cc Specialist Lead 605-789-6574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: IN 01041056A) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2024-08-28 |