Organization
RESTORE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD L LAUSENG PT (OWNER/DIRECTOR)
(605) 275-4125
Entity
Organization
Contact information
Practice address
4925 E 26TH ST, SUITE B, SIOUX FALLS, SD 57110-6950
(605) 275-4125
(605) 332-6616
Mailing address
4925 E 26TH ST, SUITE B, SIOUX FALLS, SD 57110-6950
(605) 275-4125
(605) 332-6616
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1178
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4995060
BCBS NUMBER
SD
05
—
5833562
—
SD
Enumeration date
04/17/2006
Last updated
08/22/2020
Update your record
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