| NPI | 1881647246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY WEEKS CEO/CAO 605-444-5409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-07-28 |