NPI | 1073868758 |
---|---|
Entity Type | Organization |
Authorized Contact | PAM A BARICKMAN Owner 605-391-3482 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 251S00000X (Licence: SD 10249596UT) |
Enumeration Date | 2012-07-18 |
Last Update Date | 2016-11-01 |