Individual
MRS. BRANDIE LYNN RAINBOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1413
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720240278
WELLMARK BCBS
SD
05
—
1720240278
—
SD
05
—
1720240278
—
WY
Enumeration date
06/26/2008
Last updated
05/13/2020
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