Organization
THE REHAB DOCTORS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER T DIETRICH MD (PRESIDENT OF CORPORATION)
(605) 721-7246
Entity
Organization
Contact information
Practice address
1136 JACKSON BLVD, SUITE 3, RAPID CITY, SD 57702-4397
(605) 721-7246
(605) 341-4501
Mailing address
1136 JACKSON BLVD, RAPID CITY, SD 57702-4396
(605) 721-7246
(605) 341-4501
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5300141945007EUF001
SD
208VP0014X
Interventional Pain Medicine Physician
5300141945007EUT001
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006332
WELLMARK BCBS
SD
01
—
115322600
WYOMING MEDICAID
SD
01
—
139018000
OWCP
SD
01
—
9211582
DAKOTACARE
SD
01
—
CF8314
RAILROAD MEDICARE
SD
Enumeration date
11/30/2005
Last updated
09/26/2013
Update your record
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