Individual
NISSA KVIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-8230
Mailing address
6822 PORTHCAWL CT, RAPID CITY, SD 57702-6972
(701) 740-9642
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1688
SD
225100000X
Physical Therapist
8721
MN
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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