NPI | 1831230408 |
---|---|
Doing Business As | AVERA TEA MEDICAL CLINIC |
Entity Type | Organization |
Authorized Contact | RONALD J FARR Sr Vice President Of Finance 605-368-9899 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2025-09-11 |