Organization
MISSOURI BREAKS MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY J O'LEARY (OWNER)
(605) 964-3418
Entity
Organization
Contact information
Practice address
HC 64 BOX 52, TIMBER LAKE, SD 57656-9740
(605) 964-3418
(605) 934-3415
Mailing address
HC 64 BOX 52, TIMBER LAKE, SD 57656-9740
(605) 964-3418
(605) 934-3415
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2007
Last updated
10/28/2010
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