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1920 South Dakota Hwy 10 Sisseton SD 57262-2512 | |
(605) 698-3522 | |
(605) 698-4465 |
Full Name | |
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Speciality | Clinic/center |
Location | 1920 South Dakota Hwy 10, Sisseton, South Dakota |
Authorized Official Name and Position | Leah Meyer Thielen (OWNER) |
Authorized Official Contact | 6056983522 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1920 South Dakota Hwy 10 Sisseton SD 57262-2512 Ph: (605) 698-3522 | 1920 South Dakota Hwy 10 Sisseton SD 57262-2512 Ph: (605) 698-3522 |
NPI Number | 1972615995 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 02/28/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972615995 | NPI | - | NPPES |
016355400 | Medicaid | MN | |
4999408 | Other | SD | BCBS |
3C877TH | Other | MN | BCBS |
12608 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Us Dept Of Health & Human Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lake Traverse Dr, Sisseton, SD 57262 Phone: 605-698-7606 | |
Sisseton Wahpeton Health Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lake Traverse Dr, Sisseton, SD 57262 Phone: 605-698-7606 | |