Healthcare Provider Details

I. General information

NPI: 1144659962
Provider Name (Legal Business Name): TRUSTED CHOICE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 LINCOLN AVE NE
WATERTOWN SD
57201-7398
US

IV. Provider business mailing address

1134 LINCOLN AVE NE
WATERTOWN SD
57201-7398
US

V. Phone/Fax

Practice location:
  • Phone: 605-881-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0447
License Number StateSD

VIII. Authorized Official

Name: DAVID FALCONER
Title or Position: OWNER/MANAGER
Credential:
Phone: 605-881-1100