Individual
TYRELL O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7220 MOUNT RUSHMORE RD, RAPID CITY, SD 57702-8754
(605) 341-1414
Mailing address
PO BOX 6850, RAPID CITY, SD 57709-6850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2455
SD
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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