| NPI | 1821038514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MENGENHAUSEN CEO 605-772-4574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 122300000X Dentist | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-09-28 |