| NPI | 1154988707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY J FROCK Contracting & Credentialing Special 605-789-6661 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |