| NPI | 1144570995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL P. JENNER Nurse Practitioner 605-783-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: SD CP000033) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |