Organization
SOUTH DAKOTA STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN STANLEY (ASSISTANT ATHLETIC DIRECTOR)
(605) 688-5299
Entity
Organization
Contact information
Practice address
2820 HPER CTR, BROOKINGS, SD 57007-1497
(605) 688-4003
Mailing address
2820 HPER CTR, BROOKINGS, SD 57007-1497
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0521
SD
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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