Healthcare Provider Details

I. General information

NPI: 1487152146
Provider Name (Legal Business Name): DX THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16734 BIA RTE 8 ARMSTRONG
GETTYSBURG SD
57442
US

IV. Provider business mailing address

PO BOX 905
EAGLE BUTTE SD
57625-0905
US

V. Phone/Fax

Practice location:
  • Phone: 605-222-3934
  • Fax:
Mailing address:
  • Phone: 605-222-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIRSTEN DUCHENEAUX
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT
Phone: 605-222-3934