# BADLANDS PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508340563
- **Authorized official:** TIM WALD (OWNER)
- **Authorized official phone:** (605) 222-7336

## Contact information

- **Practice address:** 910 MAIN ST, WALL, SD 57790
- **Practice address phone:** (605) 222-7336
- **Mailing address:** 505 KANSAS CITY ST STE 3, RAPID CITY, SD 57701-3673
- **Mailing address phone:** (605) 222-7336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2018
- **Last updated:** 09/17/2018