Individual
KIP D CHESMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
575 N SIOUX POINT RD, DAKOTA DUNES, SD 57049-5312
(605) 217-2667
(605) 217-2900
Mailing address
575 N SIOUX POINT RD, DAKOTA DUNES, SD 57049-5312
(605) 217-2667
(605) 217-2900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0821
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0763219
—
IA
01
—
31824
BCBS IOWA
IA
05
—
421480644-34
—
NE
01
—
4993432
BCBS SOUTH DAKOTA
SD
05
—
5833242
—
SD
Enumeration date
03/24/2006
Last updated
06/21/2013
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