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THE REHAB DOCTORS PC

Physicians Pain Medicine Interventional Pain Medicine

Provider NPI: 1932183308

Organization Information:
Organization Name:  THE REHAB DOCTORS PC
Organization is not Subpart
Authorized Official:  CHRISTOPHER T DIETRICH  PRESIDENT OF CORPORATION  605-721-7246

Practice Location:
1136 JACKSON BLVD SUITE 3 RAPID CITY, SD 57702-4397 US
Tel: 605-721-7246  Fax: 605-341-4501

Business Mailing Address:
1136 JACKSON BLVD  RAPID CITY, SD 57702-4396 US
Tel: 605-721-7246  Fax: 605-341-4501

NPI Information:
NPI: 1932183308
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N208VP0014XPhysicians
Pain Medicine
Interventional Pain Medicine
SD5300141945007EUT001
Y208100000XPhysicians
Physical Medicine & Rehabilitation
SD5300141945007EUF001

Other Provider Identifiers:

IssuerNumberStateType
DAKOTACARE9211582SD01
OWCP139018000SD01
WELLMARK BCBS0006332SD01
WYOMING MEDICAID115322600SD01
RAILROAD MEDICARECF8314SD01



American Medical Association 2012 taxonomy code information

Code: 208100000X

Type:

Classification:



Definition:



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