| NPI | 1285964494 |
|---|---|
| Other Name | WAGNER COMMUNITY CLINIC AVERA |
| Entity Type | Organization |
| Authorized Contact | BRYAN SLABA CEO 605-384-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: SD 43D0407563) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2010-01-11 |