Provider First Line Business Practice Location Address:
2805 FIFTH STREET
Provider Second Line Business Practice Location Address:
REGIONAL MEDICAL CLINIC-PODIATRY
Provider Business Practice Location Address City Name:
RAPID CITY
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57701-7306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-719-5700
Provider Business Practice Location Address Fax Number:
605-719-5775
Provider Enumeration Date:
06/17/2011