AVERA QUEEN OF PEACE NPI 1710184569

NPI Information

AVERA QUEEN OF PEACE is a prosthetic orthotic supplier in Mitchell, SD. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. AVERA QUEEN OF PEACE NPI is 1710184569. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Orthopedics & Sports Medicine.

The provider's business location address is:

625 N FOSTER ST
SUITE 200
MITCHELL, SD
ZIP 57301-969
Phone: (605) 996-3963
Fax: (605) 996-0718

The provider's authorized official is Douglas Ekeren .
The authorized official title is President/ceo and has the following contact phone number (605) 668-8322.

The enumeration date for this NPI number is 6/27/2007 and was last updated on 8/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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