Healthcare Provider Details

I. General information

NPI: 1174712707
Provider Name (Legal Business Name): GREAT PLAINS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 E CHERRY ST
VERMILLION SD
57069-2602
US

IV. Provider business mailing address

PO BOX 632658
CINCINNATI OH
45263-2658
US

V. Phone/Fax

Practice location:
  • Phone: 605-624-7246
  • Fax: 605-624-7177
Mailing address:
  • Phone: 702-818-5000
  • Fax: 702-818-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC ELDON DOUGLASS
Title or Position: CHIEF CLINICAL OFFICER
Credential: PT
Phone: 941-870-4401