| NPI | 1720081524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ALLEN CROUCH Physician/Owner 712-262-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2009-08-31 |