| NPI | 1174107072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAC SCHMIDT Provider Enrollment 605-541-1140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 261QH0700X Clinic/Center Hearing and Speech |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2022-03-24 |