Healthcare Provider Details

I. General information

NPI: 1659418960
Provider Name (Legal Business Name): CORNERSTONE THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 04/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PAUL GUST RD SUITE 109
CHAMBERLAIN SD
57325-1031
US

IV. Provider business mailing address

200 PAUL GUST RD SUITE 109
CHAMBERLAIN SD
57325-1031
US

V. Phone/Fax

Practice location:
  • Phone: 605-234-1287
  • Fax:
Mailing address:
  • Phone: 605-234-1287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JONI BICH
Title or Position: MEMBER
Credential:
Phone: 605-234-1287