Healthcare Provider Details

I. General information

NPI: 1336771005
Provider Name (Legal Business Name): INTEGRATED MASSAGE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N LAWLER ST
MITCHELL SD
57301-2635
US

IV. Provider business mailing address

305 N LAWLER ST
MITCHELL SD
57301-2635
US

V. Phone/Fax

Practice location:
  • Phone: 605-999-4793
  • Fax:
Mailing address:
  • Phone: 605-999-4793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERIKA MAE BIER
Title or Position: OWNER
Credential: LMT
Phone: 605-999-4793