| |
1101 E Holly Blvd Brandon SD 57005-1426 | |
(605) 582-3853 | |
(605) 582-3855 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 1101 E Holly Blvd, Brandon, South Dakota |
Authorized Official Name and Position | Julie N Norton (SR VICE PRESIDENT OF FINANCE) |
Authorized Official Contact | 6053227818 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 86430 Sioux Falls SD 57118-6430 Ph: (605) 322-4900 | 1101 E Holly Blvd Brandon SD 57005-1426 Ph: (605) 582-3853 |
NPI Number | 1285701870 |
---|---|
Provider Enumeration Date | 11/29/2006 |
Last Update Date | 05/10/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285701870 | NPI | - | NPPES |
0716829 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
Chirosport Brandon, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 125 E Holly Blvd, Brandon, SD 57005 Phone: 605-582-8800 |