| Mark Bontreger Inc | |
|
525 5th St Se Suite L-13 Watertown SD 57201-4940 | |
| (605) 882-0800 | |
| (605) 882-0861 |
| Full Name | Mark Bontreger Inc |
|---|---|
| Speciality | Psychologist |
| Location | 525 5th St Se, Watertown, South Dakota |
| Authorized Official Name and Position | Mark Eldon Bontreger (PRESIDENT) |
| Authorized Official Contact | 6058820800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Bontreger Inc 525 5th St Se Suite L-13 Watertown SD 57201-4940 Ph: (605) 882-0800 | Mark Bontreger Inc 525 5th St Se Suite L-13 Watertown SD 57201-4940 Ph: (605) 882-0800 |
| NPI Number | 1942496047 |
|---|---|
| Provider Enumeration Date | 09/21/2007 |
| Last Update Date | 06/24/2011 |
| Medicare PECOS PAC ID | 7315929031 |
|---|---|
| Medicare Enrollment ID | O20040604000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942496047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 364 (South Dakota) | Primary |
| Provider Name | Mark E Bontreger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861505190 PECOS PAC ID: 6507850195 Enrollment ID: I20040414001555 |
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