Full Name | |
---|---|
Speciality | Family Medicine |
Location | 112 7th Avenue, Wall, South Dakota |
Authorized Official Name and Position | John Y Pierce (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6057559142 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 9263 Belfast ME 04915-9263 Ph: (605) 755-7649 | 112 7th Avenue Wall SD 57790 Ph: (605) 279-2149 |
NPI Number | 1801212402 |
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Provider Enumeration Date | 03/07/2014 |
Last Update Date | 08/06/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801212402 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |