Individual
MATTHEW DAVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 ANAMARIA DR, RAPID CITY, SD 57701-7366
(605) 721-4700
Mailing address
216 ANAMARIA DR, RAPID CITY, SD 57701-7366
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP003907
SD
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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