Individual
TIMOTHY EDWARD SIMONICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2116 JACKSON BLVD, RAPID CITY, SD 57702-3495
(605) 755-2273
Mailing address
2116 JACKSON BLVD, RAPID CITY, SD 57702-3495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/13/2019
Last updated
03/06/2020
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