| NPI | 1770680787 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP WILMOT |
| Entity Type | Organization |
| Authorized Contact | DAVID FLICEK President/CEO 605-322-7916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-09-10 |