Provider First Line Business Practice Location Address: 
601 E 7TH ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
PLATTE
    Provider Business Practice Location Address State Name: 
SD
    Provider Business Practice Location Address Postal Code: 
57369-2123
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
605-337-1501
    Provider Business Practice Location Address Fax Number: 
605-337-3360
    Provider Enumeration Date: 
10/27/2022