| NPI | 1184626962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNE KOPFMANN Clinic Administrator 605-352-8691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: SD 43D0407501) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2019-01-24 |