| NPI | 1255677084 |
|---|---|
| Doing Business As | ESSENTIA HEALTH SOUTH UNIVERSITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | ALAN J HURLEY COO 701-364-7667 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2024-03-01 |