Organization
FOUNDERS PARK CLINIC, PLLC
Active
Organization
FOUNDERS PARK CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN S SPAHN MD (PRESIDENT)
(605) 791-5959
Entity
Organization
Contact information
Practice address
211 FOUNDERS PARK DR, SUITE 3, RAPID CITY, SD 57701-8098
(605) 791-5959
(605) 791-5960
Mailing address
211 FOUNDERS PARK DR, SUITE 3, RAPID CITY, SD 57701-8098
(605) 791-5959
(605) 791-5960
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
LLC ID# DL020085
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6702250
—
SD
Enumeration date
09/24/2011
Last updated
09/24/2011
Update your record
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