Individual
KEN RIVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
HWY 18 E, PHS INDIAN HEALTH HOSPITAL, PINE RIDGE, SD 57770-1201
(605) 867-3192
Mailing address
PO BOX 1201, EAST HIGHWAY 18, PINE RIDGE, SD 57770-1201
(605) 867-3192
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13030
CT
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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