| NPI | 1386911923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA MARIE HUNTER Owner 605-212-0894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: SD 1096) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |