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General NPI Number Information
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NPI Number | 1568652873
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Entity Type | Organization
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Legal Business Name | WCOS, PC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 130 YANKEE ST
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City | SPEARFISH
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State | SD
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Zip | 57783-2948
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Country | US
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Telephone | 605-722-9267
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Fax |
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Provider Business Mailing Address
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Address Line | 130 YANKEE ST
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City | SPEARFISH
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State | SD
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Zip | 57783-2948
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Country | US
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Telephone | 605-722-9267
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANN K CHURCH
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Credential | MD
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Telephone | 605-722-9267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 3328
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License Number State | SD
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