Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1877 | SD |
NPI | 1073945895 |
---|---|
Provider Name | Dr. Katie Sandvig |
First Address | Rapid City, SD 57702-8529 |
Second Address | Rapid City, SD 57702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2013 |
Last Update Date | 10/05/2019 |