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General NPI Number Information
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NPI Number | 1164093670
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Entity Type | Organization
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Legal Business Name | STRESS BUSTERS LLC
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 2650 JACKSON BLVD STE 8
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City | RAPID CITY
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State | SD
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Zip | 57702-3474
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Country | US
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Telephone | 605-646-3685
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Fax |
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Provider Business Mailing Address
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Address Line | 1026 RACINE ST
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City | RAPID CITY
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State | SD
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Zip | 57701-1070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANA MOHR
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Credential |
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Telephone | 605-646-3685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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