Organization
AVERA MCKENNAN
Active
Organization
AVERA MCKENNAN
Active
Other names
Avera McKennan Outpatient Therapy Services - Brandon
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH PLACE MD (PRESIDENT/CEO)
(605) 322-7903
Entity
Organization
Contact information
Practice address
103 N SPLITROCK BLVD, BRANDON, SD 57005-1529
(605) 582-3908
(605) 582-3349
Mailing address
PO BOX 5045, ATTN: PROVIDER ENROLLMENT PT FINANCIAL SERVICES, SIOUX FALLS, SD 57117-5045
(605) 322-6428
(605) 322-6499
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
10563
SD
Other
Enumeration date
11/13/2008
Last updated
10/04/2023
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