Individual
MARY E DVORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
1000 HEALTH CENTER ROAD, KYLE, SD 57752
(605) 455-8226
(605) 455-1529
Mailing address
1000 HEALTH CENTER ROAD, KYLE, SD 57752-0540
(605) 455-8227
(605) 455-2808
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10445
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10445
LICENSING STATE
NE
Enumeration date
09/29/2009
Last updated
09/29/2009
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