Individual
MR. JAMIE MICHAEL BOOMGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
800 E 21ST ST, SIOUX FALLS, SD 57105-1016
(605) 322-5000
(605) 322-5174
Mailing address
27348 461ST AVE, CHANCELLOR, SD 57015-5703
(605) 647-5338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0561
SD
Other
Enumeration date
09/22/2008
Last updated
09/22/2008
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