| NPI | 1669496337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY J REILLY Authorized Official 605-217-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-06-11 |