| NPI | 1780811778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY J BLOW Owner 605-988-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: SD 3724) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-09-01 |