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Organization

BLACK HILLS PELVIC HEALTH, LLC

Active
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Organization

BLACK HILLS PELVIC HEALTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIM WALD (OWNER)
(605) 222-7336
Entity
Organization

Contact information

Practice address
505 KANSAS CITY ST STE 3, RAPID CITY, SD 57701-3673
(605) 222-7336
Mailing address
505 KANSAS CITY ST STE 3, RAPID CITY, SD 57701-3673
(605) 222-7336

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
261QR0400X
Rehabilitation Clinic/Center

Other

Enumeration date
08/27/2018
Last updated
08/27/2018
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