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Organization

WEST RIVER EAR NOSE AND THROAT, PROF., L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACK R SCHLEIFFARTH M.D. (MEMBER-MANAGER)
(605) 791-0602
Entity
Organization

Contact information

Practice address
4940 5TH ST STE 2B, RAPID CITY, SD 57701-6026
(605) 791-0602
(605) 791-0978
Mailing address
4940 5TH ST STE 2B, RAPID CITY, SD 57701-6026
(605) 791-0602
(605) 791-0978

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0566
SD
231H00000X
Audiologist

Other

Enumeration date
08/28/2018
Last updated
02/06/2019
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