NPI | 1427090760 |
---|---|
Doing Business As | AVERA MEDICAL GROUP GREGORY |
Entity Type | Organization |
Authorized Contact | DAVID WILLIAM FLICEK President/CEO 605-322-7915 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2006-06-12 |
Last Update Date | 2023-02-10 |