Healthcare Provider Details

I. General information

NPI: 1255247748
Provider Name (Legal Business Name): MARC RATTENBORG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 W 11TH ST
YANKTON SD
57078-6865
US

IV. Provider business mailing address

310 CENTER ST
VERMILLION SD
57069-2116
US

V. Phone/Fax

Practice location:
  • Phone: 605-655-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6160
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: