Individual
PATRICE M JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLT
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2229
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2229
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
0042197
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0140070
MEDICAID
SD
05
—
5549050
—
SD
Enumeration date
03/14/2012
Last updated
03/14/2012
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