Individual
JILL BLICKENSDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT(ASCP)
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
(605) 355-2514
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
(605) 355-2514
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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