Provider First Line Business Practice Location Address:
2701 S MINNESOTA
Provider Second Line Business Practice Location Address:
LONG SMITH THERAPY DESTINY CLINIC SUITE 3
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-359-6290
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/10/2007