| 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 | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |