Healthcare Provider Details

I. General information

NPI: 1972424513
Provider Name (Legal Business Name): DANIEL HARWELL LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S WESTERN AVE STE 102
SIOUX FALLS SD
57105-6570
US

IV. Provider business mailing address

6004 W BAKKER PARK DR
SIOUX FALLS SD
57106-2421
US

V. Phone/Fax

Practice location:
  • Phone: 605-921-2747
  • Fax:
Mailing address:
  • Phone: 605-941-2747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberTM12188
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: