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General NPI Number Information
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NPI Number | 1891213567
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Entity Type | Organization
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Legal Business Name | GARCIA FAMILY CLINIC, PLLC
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 09/01/2017
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Provider Practice Location Address
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Address Line | 102 MAIN STREET PO BOX 301
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City | HAYTI
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State | SD
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Zip | 57241-0301
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Country | US
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Telephone | 605-783-2999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 301
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City | HAYTI
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State | SD
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Zip | 57241-0301
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Country | US
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Telephone | 605-783-2999
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPHINE GARCIA
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Credential | FNP-C
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Telephone | 605-783-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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