Organization
MIDWEST REGIONAL IMAGING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD L. LARSON (ADMINISTRATOR)
(605) 336-0515
Entity
Organization
Contact information
Practice address
6001 S SHARON AVE, SIOUX FALLS, SD 57108-5746
(605) 338-8811
(605) 334-9529
Mailing address
1417 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1715
(605) 336-0515
(605) 336-2874
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
50438
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200940
—
SD
Enumeration date
06/11/2006
Last updated
08/22/2020
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