Organization
KRAVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOK WILDERSON (MASSAGE THERAPIST)
(402) 822-0296
Entity
Organization
Contact information
Practice address
1040 22ND AVE S, BROOKINGS, SD 57006-2803
(605) 692-5728
Mailing address
1040 22ND AVE S, BROOKINGS, SD 57006-2803
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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