Organization
RAPID CITY ACUPUNCTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE LYNN GILLIAM L.AC (SOLE MEMBER)
(605) 415-8739
Entity
Organization
Contact information
Practice address
2720 W MAIN ST, RAPID CITY, SD 57702-8128
(605) 791-4001
(605) 791-4001
Mailing address
2720 W MAIN ST, RAPID CITY, SD 57702-8128
(605) 791-4001
(605) 791-4001
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01246
TX
Other
Enumeration date
05/10/2011
Last updated
07/05/2012
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