Healthcare Provider Details

I. General information

NPI: 1013849330
Provider Name (Legal Business Name): HAILEY JAYE PULLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E SAINT PATRICK ST STE 101
RAPID CITY SD
57701-4200
US

IV. Provider business mailing address

420 E SAINT PATRICK ST STE 101
RAPID CITY SD
57701-4200
US

V. Phone/Fax

Practice location:
  • Phone: 605-484-9019
  • Fax:
Mailing address:
  • Phone: 605-484-9019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6266
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: