Individual
RUNGKAN CLEVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
715 E STREET, EDGEMONT, SD 57735
(951) 285-5407
Mailing address
PO BOX 449, EDGEMONT, SD 57735-0449
(951) 285-5407
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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