| NPI | 1467786640 |
|---|---|
| Doing Business As | AVERA PRINCE OF PEACE OUTPATIENT THERAPY |
| Entity Type | Organization |
| Authorized Contact | DAVID FLICEK President 605-322-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: SD 10563) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2021-07-01 |