| Organization Name: | AVERA GREGORY |
| NPI Number: | 1770939530 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MCKENZIE MARIE RANDALL (PHYSICAL THERAPIST) |
| Mailing Address: | 400 Park Ave Gregory |
| State: | SD US |
| Postal Code: | 575331302 |
| Phone Number: | 6058355190 |
| Fax Number: | 6058355479 |
| NPI Enumeration Date: | 05/11/2016 |
| NPI Last Update Date: | 05/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 1767 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |