| NPI | 1770767782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE SCHUBLOOM Office Manager 605-854-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD SD 4247) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2008-01-03 |