Individual
RONALD ROGER TIBKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 FAIRWAY CIRCLE, DELL RAPIDS, SD 57022
(999) 999-9999
Mailing address
702 FAIRWAY CIR, DELL RAPIDS, SD 57022-2101
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0277
SD
Other
Enumeration date
05/15/2008
Last updated
11/04/2009
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