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Individual

MRS. JODIE MCMACKEN THORSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
4500 S PRINCE OF PEACE PL, SUITE 1, SIOUX FALLS, SD 57103-5830
(605) 322-5618
Mailing address
309 BIRCHWOOD CIR, BRANDON, SD 57005-2105
(605) 582-7922

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0126
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025846700
NE
01
1700070307
WELLMARK BCBS SD
05
1700070307
IA
05
1700070307
MN
01
9290265
DAKOTACARE
Enumeration date
08/28/2007
Last updated
07/26/2010
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