| NPI | 1689831091 |
|---|---|
| Other Name | SPEARFISH CLINIC |
| Entity Type | Organization |
| Authorized Contact | JASON W GORMAN Administrator 605-341-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SD 0370) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SD 0370) |
| 207ND0900X Dermatology, Dermatopathology (Licence: SD 0370) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: SD 0370) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2015-01-30 |