| NPI | 1194873851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN HOGAN RN Clinic Manager 605-428-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 4884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 5054) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |