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1818 W Fulton St Suite 102 Rapid City SD 57702-4377 | |
| (605) 787-1040 | |
| (605) 787-1034 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1818 W Fulton St, Rapid City, South Dakota |
| Authorized Official Name and Position | Brett Nelson (OWNER) |
| Authorized Official Contact | 6057871040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2257 Chesterton IN 46304-0357 Ph: (219) 926-8320 | 1818 W Fulton St Suite 102 Rapid City SD 57702-4377 Ph: (605) 787-1040 |
| NPI Number | 1396138392 |
|---|---|
| Provider Enumeration Date | 03/15/2015 |
| Last Update Date | 08/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396138392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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