Individual
RYDER CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1807 WILLIAMS ST, STURGIS, SD 57785-1142
(605) 347-3003
Mailing address
1807 WILLIAMS ST, STURGIS, SD 57785-1142
(605) 347-3003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
46-6036107
SD
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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