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353 Fairmont Blvd Rapid City SD 57701-7375 | |
| (605) 755-5700 | |
| (605) 755-5766 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 353 Fairmont Blvd, Rapid City, South Dakota |
| Authorized Official Name and Position | Steven Maser (VICE PRESIDENT, MEDICAL AFFAIRS) |
| Authorized Official Contact | 6057556700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 860013 Minneapolis MN 55486-0013 Ph: (605) 755-5700 | 353 Fairmont Blvd Rapid City SD 57701-7375 Ph: (605) 755-5700 |
| NPI Number | 1184310609 |
|---|---|
| Provider Enumeration Date | 04/17/2023 |
| Last Update Date | 04/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184310609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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