MARY FANTA
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1508774126- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 400 22ND AVE, BROOKINGS, SD, 570062447
- Phone
- (605) 697-9500
Specialties & Taxonomies
Physician Assistant
Primary