| Back To Health Wellness Clinic | |
|
343 Quincy St Suite 100 Rapid City SD 57701-3700 | |
| (605) 718-7312 | |
| (605) 718-9008 |
| Full Name | Back To Health Wellness Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 343 Quincy St, Rapid City, South Dakota |
| Authorized Official Name and Position | Bruce Alvin Crisman (PRESIDENT) |
| Authorized Official Contact | 6057187312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Back To Health Wellness Clinic 343 Quincy Street Suite 100 Rapid City SD 57701-3700 Ph: (605) 718-7312 | Back To Health Wellness Clinic 343 Quincy St Suite 100 Rapid City SD 57701-3700 Ph: (605) 718-7312 |
| NPI Number | 1760597116 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 03/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760597116 | NPI | - | NPPES |
| 7600534 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 774 (South Dakota) | Primary |
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