Individual
JERRY MCREAVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 N 5TH ST, HOT SPRINGS, SD 57747-1480
(605) 747-2000
Mailing address
PO BOX 236, HOT SPRINGS, SD 57747-0236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
953
CO
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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