Individual
CLARK MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 E 20TH ST, SIOUX FALLS, SD 57105-1012
(605) 334-6730
Mailing address
1100 E 26TH ST, SIOUX FALLS, SD 57105-4046
(605) 338-7098
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
PENDING
SD
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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