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Organization
BLACK HILLS PEDIATRIC THERAPY, LLC
Active
Organization
BLACK HILLS PEDIATRIC THERAPY, LLC
Active
Other names
Dakota Stretch Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM WALD PT, DPT (PT, DPT - OWNER)
(605) 222-3773
Entity
Organization
Contact information
Practice address
505 KANSAS CITY ST., SUITE #3, RAPID CITY, SD 57701-3673
(605) 222-3773
(605) 791-0631
Mailing address
505 KANSAS CITY ST., SUITE #3, RAPID CITY, SD 57701-3673
(605) 222-3773
(605) 791-0631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/26/2012
Last updated
01/09/2020
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