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General NPI Number Information
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NPI Number | 1235196056
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Entity Type | Organization
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Legal Business Name | MCHALE INSTITUTE, P.C.
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 3720 W 69TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108
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Country | US
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Telephone | 605-339-4464
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Fax | 605-339-0309
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Provider Business Mailing Address
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Address Line | 3720 W 69TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108
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Country | US
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Telephone | 605-339-4464
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Fax | 605-339-0309
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Authorized Official
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Title or Position | MANAGER
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Name | LARRY R BOLLER
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Credential | MBA
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Telephone | 402-435-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 1762
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License Number State | SD
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