Individual
ELLIE V DIERKHISING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
4526 CANDLEWOOD PL APT 201, RAPID CITY, SD 57702-0196
(218) 820-8674
Mailing address
4526 CANDLEWOOD PL APT 201, RAPID CITY, SD 57702-0196
(218) 820-8674
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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