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Organization
CENTRAL STATES DIAGNOSTIC
Active
Organization
CENTRAL STATES DIAGNOSTIC
Active
Other names
Central States Diagnostic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CATHERINE J DICE ECHOCARDIOGRAPHER (OWNER)
(605) 366-5397
Entity
Organization
Contact information
Practice address
25769 COTTONWOOD AVE, SIOUX FALLS, SD 57107-6402
(605) 366-5397
(605) 256-3259
Mailing address
1716 S MARION RD, SIOUX FALLS, SD 57106-3643
(605) 366-5397
(605) 256-3259
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002272
BLUE SHIELD
SD
05
—
7290070
—
SD
Enumeration date
09/16/2006
Last updated
06/03/2020
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