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General NPI Number Information
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NPI Number | 1780615872
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Entity Type | Individual
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Provider Name | VICTORIA J ANTLE-VLACH MD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 1000 W 4TH ST SUITE 13
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City | YANKTON
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State | SD
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Zip | 57078-3730
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Country | US
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Telephone | 605-668-8795
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Fax | 605-668-9705
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Provider Business Mailing Address
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Address Line | 1000 W 4TH ST SUITE 13
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City | YANKTON
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State | SD
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Zip | 57078-3730
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Country | US
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Telephone | 605-668-8795
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Fax | 605-668-9705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 8743
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License Number State | SD
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