Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FLICEK (CEO/PRESIDENT)
(605) 322-8000
Entity
Organization
Contact information
Practice address
2100 S MARION ROAD, STE 125, SIOUX FALLS, SD 57106-3645
(605) 322-3790
Mailing address
2100 S MARION ROAD, STE 125, SIOUX FALLS, SD 57106-3645
(605) 322-3790
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
09/01/2016
Last updated
10/24/2018
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