Individual
LARRY S PRAIRIE CHICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1714 ABBEY RD, PIERRE, SD 57501-7805
(605) 224-8841
Mailing address
1714 ABBEY RD, PIERRE, SD 57501-7805
(605) 224-8841
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9607858
SD
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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