Individual
AMY RED OWL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3505 CAMBELL ST, RAPID CITY, SD 57701-0141
(605) 716-1837
(605) 348-0479
Mailing address
2920 SHERIDAN LAKE RD, RAPID CITY, SD 57702-8191
(605) 716-1837
(605) 348-0479
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
CHW509
SD
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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