# MISSOURI BREAKS MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235329053
- **Authorized official:** MR. TIMOTHY J O'LEARY (OWNER)
- **Authorized official phone:** (605) 964-3418

## Contact information

- **Practice address:** HC 64 BOX 52, TIMBER LAKE, SD 57656-9740
- **Practice address phone:** (605) 964-3418
- **Practice address fax:** (605) 934-3415
- **Mailing address:** HC 64 BOX 52, TIMBER LAKE, SD 57656-9740
- **Mailing address phone:** (605) 964-3418
- **Mailing address fax:** (605) 934-3415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/27/2007
- **Last updated:** 10/28/2010