Healthcare Provider Details

I. General information

NPI: 1295426898
Provider Name (Legal Business Name): DTZ HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S MARY BETH AVE
SIOUX FALLS SD
57106-4872
US

IV. Provider business mailing address

1901 S MARY BETH AVE
SIOUX FALLS SD
57106-4872
US

V. Phone/Fax

Practice location:
  • Phone: 605-728-2666
  • Fax: 605-277-3016
Mailing address:
  • Phone: 605-728-2666
  • Fax: 605-277-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SEDASKIA A SEMAIVULA
Title or Position: MD
Credential:
Phone: 605-728-2666