| NPI | 1649417072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE LEAH BIRNEY Registered Nurse/Ambulatory Care 605-698-7606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: SD RO28333) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |