Individual
REBECCA MAE GERVAIS-LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1515 5TH AVE STE 101, BELLE FOURCHE, SD 57717-6032
(605) 892-4845
Mailing address
1515 5TH AVE STE 101, BELLE FOURCHE, SD 57717-6032
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1264
SD
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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