Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2015-01-09
- Last updated
- 2015-01-09
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 910 N MAIN AVE, SUITE 101
- City
- TEA SD
- Postal code
- 570640580
- Phone
- 605-498-4746
Organization contact
- Name
- MELISSA BRANDNER
- Title
- Owner
- Phone
- 6054984746
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.