Individual
JOANN RAE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
529 N MAIN ST, SPEARFISH, SD 57783-2345
(605) 641-4674
Mailing address
805 HARVARD ST APT A, SPEARFISH, SD 57783-1898
(605) 641-4674
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT11445
SD
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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