| NPI | 1316601743 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP EAR, NOSE & THROAT |
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM FLICEK President/CEO 605-322-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2021-10-22 |