Organization
CHILD AND ADOLESCENT NEUROLOGY PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE D SANCHEZ MD (OWNER)
(605) 334-8000
Entity
Organization
Contact information
Practice address
117 W 39TH ST, SIOUX FALLS, SD 57105-5732
(605) 334-8000
(605) 334-8001
Mailing address
PO BOX 89432, SIOUX FALLS, SD 57109-9432
(605) 334-8000
(605) 334-8001
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025804700
—
NE
05
—
15135
—
ND
Enumeration date
08/25/2009
Last updated
07/30/2015
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