| Independent Medicine Prof Llc | |
|
204 E Lake Dr Estelline SD 57234-6615 | |
| (605) 873-2133 | |
| (605) 873-2133 |
| Full Name | Independent Medicine Prof Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 204 E Lake Dr, Estelline, South Dakota |
| Authorized Official Name and Position | Annette M Bosworth (PRESIDENT/CEO) |
| Authorized Official Contact | 6053716899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Medicine Prof Llc 204 E Lake Dr Estelline SD 57234-6615 Ph: (605) 873-2133 | Independent Medicine Prof Llc 204 E Lake Dr Estelline SD 57234-6615 Ph: (605) 873-2133 |
| NPI Number | 1740590413 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 06/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740590413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 6055 (South Dakota) | Primary |
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Sanford Clinic Estelline Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 305 Hospital Dr, Estelline, SD 57234 Phone: 605-873-2222 Fax: 605-873-2182 |