Individual
TRAVIS BOLSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
400 22ND AVE, BROOKINGS, SD 57006-2450
(605) 697-7336
Mailing address
45790 216A ST, VOLGA, SD 57071-6820
(605) 695-0594
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
097556
IA
225100000X
Physical Therapist
Primary
2166
SD
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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