Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 4876 | SD |
NPI | 1316902257 |
---|---|
Provider Name | Michelle A. Turner |
First Address | Miller, SD 57362-1238 |
Second Address | Miller, SD 57362-1238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 12/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5611003 | (05) | SD |