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General NPI Number Information
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NPI Number | 1477938835
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Entity Type | Organization
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Legal Business Name | LOOPING PROFESSIONALS LLC
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 2120 W MAIN ST STE 7
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City | RAPID CITY
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State | SD
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Zip | 57702-2465
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Country | US
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Telephone | 605-721-7427
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 W MAIN ST STE 7
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City | RAPID CITY
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State | SD
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Zip | 57702-2465
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Country | US
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Telephone | 605-721-7427
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TERESA JEAN ROBIN
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Credential | HIS
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Telephone | 605-721-7427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 350H
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License Number State | SD
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