Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-05-14
- Last updated
- 2015-06-29
Specialties
Licenses
- License IA
- 06944
- License SD
- 1105
Location
- Practice location
- 710 E 1ST ST
- City
- TEA SD
- Postal code
- 570643209
- Phone
- 605-498-2273
Organization contact
- Name
- LAURA KOELE
- Title
- Member
- Phone
- 6054982273
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.