Organization
QUEEN CITY REGIONAL MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANA GROUT (ADMINISTRATOR)
(605) 642-8414
Entity
Organization
Contact information
Practice address
1420 N. 10TH STREET, SPEARFISH, SD 57783-1532
(605) 642-8414
(605) 642-8618
Mailing address
1420 N 10TH ST, SPEARFISH, SD 57783-1532
(605) 642-8414
(605) 642-8618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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