Healthcare Provider Details

I. General information

NPI: 1952334013
Provider Name (Legal Business Name): HOWARD PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 SOUTH MAIN ST.
HOWARD SD
57349
US

IV. Provider business mailing address

131 SOUTH MAIN ST. PO BOX 39
HOWARD SD
57349
US

V. Phone/Fax

Practice location:
  • Phone: 605-772-2131
  • Fax: 605-772-2041
Mailing address:
  • Phone: 605-772-2131
  • Fax: 701-772-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. WESLEY ALAN MENTELE
Title or Position: PRESIDENT
Credential: MPT
Phone: 605-772-2131