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Individual

SHANNON MICHELLE BLOTSKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
255 TEXAS ST, RAPID CITY, SD 57701-7319
(605) 342-0255
Mailing address
14457 APPLE DR, PIEDMONT, SD 57769-2101

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0435
SD

Other

Enumeration date
09/26/2012
Last updated
09/26/2012
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