Provider First Line Business Practice Location Address:
520 S. 1ST AVE
Provider Second Line Business Practice Location Address:
USD SCOTTISH RITE CHILDREN'S CLINIC
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57104-6902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-336-7561
Provider Business Practice Location Address Fax Number:
605-330-9820
Provider Enumeration Date:
04/30/2007