| NPI | 1801901863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY J LIUDAHL Provider And Owner 605-665-6820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SD 0389) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-02-22 |