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Avera Queen Of Peace
Prosthetic/Orthotic Supplier in Mitchell, South Dakota
NPI 1710184569

Avera Queen Of Peace is a Prosthetic/Orthotic Supplier based in Mitchell, SD. Avera Queen Of Peace practices in Mitchell, SD. The NPI Number for Avera Queen Of Peace is 1710184569 and holds a License No. 100-1023 (South Dakota).

The current practice location address for Avera Queen Of Peace is 625 N Foster St, Mitchell, SD and can be reached out via phone at 605-996-3963 and via fax at 605-996-0718.

Location: 625 N Foster St, Mitchell, SD, 57301-2969
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1710184569
Provider Name
Avera Queen Of Peace
Credential
Provider Entity Type
Organization
Address
625 N Foster St, Mitchell, SD, 57301-2969
Phone Number
605-996-3963
Fax Number
605-996-0718
Provider Enumeration Date
06/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0100130 05 SD
institution
Provider Business Practice Location Address Details
Address
625 N Foster St
City
Mitchell
State
South Dakota
Zip
57301-2969
Phone Number
605-996-3963
Fax Number
605-996-0718
person
Provider Business Mailing Address Details
Address
625 N Foster St
City
Mitchell
State
South Dakota
Zip
57301-2969
Phone Number
605-996-3963
Fax Number
605-996-0718
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
100-1023 (South Dakota)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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