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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