| NPI | 1154159747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON EMRY Medical Director 605-370-3054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 207RN0300X Internal Medicine, Nephrology | |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-08-28 |