| NPI | 1538613633 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP OPTOMETRY WINDOM |
| Entity Type | Organization |
| Authorized Contact | DAVID FLICEK CEO/President 605-322-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2018-10-24 |