Organization
J R ANESTHESIA PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY J DEGEN CRNA (OWNER)
(605) 381-5104
Entity
Organization
Contact information
Practice address
3615 5TH ST, 100, RAPID CITY, SD 57701-6014
(605) 343-6714
(605) 343-2130
Mailing address
2014 HARNEY DR, RAPID CITY, SD 57702-5113
(605) 381-5104
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
09/08/2011
Last updated
01/16/2020
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