Organization
AVERA MCKENNAN
Active
Other names
Avera Doctors Plaza Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N NORTON (SENIOR VP OF FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
1001 E 21ST ST, STE. 403, SIOUX FALLS, SD 57105-1033
(605) 322-1745
(605) 322-1746
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025121100
—
NE
01
—
370624200
DEPT OF LABOR
SD
01
—
543R6AV
BLUE PLUS
MN
Enumeration date
02/08/2006
Last updated
03/12/2012
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