| NPI | 1316279391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C. VIDOLOFF Physician 605-229-2108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SD 2759) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2010-02-02 |