MEDICARE: SUNDOG REHABILITATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	1487	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S105011	OTHER		MEDICARE PTAN

General Provider Information

NPI Number	:	1285925453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNDOG REHABILITATION LLC

Provider Business Mailing Address
First Line	:	3064 COVINGTON ST
Second Line	:	SUITE 104
City	:	RAPID CITY
State	:	SD
Zip	:	57703-7207
Country	:	US
Telephone Number	:	605-787-2719
Fax Number	:	605-718-4452

Provider Business Practice Location Address
First Line	:	3064 COVINGTON ST
Second Line	:	SUITE 104
City	:	RAPID CITY
State	:	SD
Zip	:	57703-7207
Country	:	US
Telephone Number	:	605-787-2719
Fax Number	:	605-718-4452

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	SARAH PETTYJOHN
Credential	:	DPT
Telephone Number	:	605-787-2719

Provider Enumeration Date	:	04/22/2011
Last Update Date	:	11/25/2015

Similar Medicare Providers

1366656118 — SARAH PETTYJOHN
Practice Location Address:

3064 COVINGTON ST , SUITE 104
RAPID CITY, SD
57703-7207

Practice Phone: 605-787-2719
Practice Fax: 605-718-4452

1720466501 — KENDRA MARIE WEBSTER PT
Practice Location Address:

3064 COVINGTON ST , SUITE 104
RAPID CITY, SD
57703-7207

Practice Phone: 605-787-2719
Practice Fax:

1760835052 — RCLALC,LLC
Practice Location Address:

409 E FAIRLANE DR
RAPID CITY, SD
57701-7207

Practice Phone: 605-399-1551
Practice Fax:

1295188639 — RCLALC, LLC
Practice Location Address:

409 E FAIRLANE DR
RAPID CITY, SD
57701-7207

Practice Phone: 605-399-1551
Practice Fax:

1851847065 — HEATHER KAY OCHOCKI MA LAC
Practice Location Address:

405 E FAIRLANE DR
RAPID CITY, SD
57701-7207

Practice Phone: 605-642-7093
Practice Fax:

1932874658 — CHELSEA LAUREN DUPRE CNP
Practice Location Address:

405 E FAIRLANE DR
RAPID CITY, SD
57701-7207

Practice Phone: 605-513-5197
Practice Fax: 605-513-5198

Directions to “SUNDOG REHABILITATION LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.