Organization
SPECIALTY CLINIC OF SIOUX CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAE BERGH PA-C (MANAGER)
(605) 553-6458
Entity
Organization
Contact information
Practice address
400 BAYHILL CIR, DAKOTA DUNES, SD 57049-5092
(605) 553-6458
Mailing address
166 SADDLEBROOK CT, NORTH SIOUX CITY, SD 57049-5443
(605) 553-6458
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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