NPI | 1457096133 |
---|---|
Doing Business As | AVERA MEDICAL GROUP COMPREHENSIVE WEIGHT MANAGEMENT |
Entity Type | Organization |
Authorized Contact | DAVID WILLIAM FLICEK President/CEO 605-322-7915 |
Organization Subpart ? | No |
Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine |
Enumeration Date | 2022-04-28 |
Last Update Date | 2022-04-28 |