NPI 1710184569

Avera Queen of Peace

Organisation Prosthetic/Orthotic Supplier Mitchell, SD

Practice location

Address: 625 N Foster St Suite 200, Mitchell, SD 57301-2969
Phone: (605) 996-3963
Fax: (605) 996-0718

Authorised official

Name: Douglas Ekeren
Title: President/Ceo
Phone: (605) 668-8322

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence 100-1023 (SD)

Other Prosthetic/Orthotic Supplier providers in South Dakota →

Registry record

NPI: 1710184569
Entity type: Organization
NPI issued: 27 Jun 2007
Record last updated: 20 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.