| NPI | 1275984403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GARRY Clinic Administrative Manager 605-322-6792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001103) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2016-06-29 |