Provider Demographics
NPI:1114382447
Name:HOVDES PHYSICAL THERAPY CLINIC LLC
Entity Type:Organization
Organization Name:HOVDES PHYSICAL THERAPY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-532-4212
Mailing Address - Street 1:312 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:SD
Mailing Address - Zip Code:57225
Mailing Address - Country:US
Mailing Address - Phone:605-532-4212
Mailing Address - Fax:605-532-1343
Practice Address - Street 1:312 1ST AVE W
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:SD
Practice Address - Zip Code:57225
Practice Address - Country:US
Practice Address - Phone:605-532-4212
Practice Address - Fax:605-532-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty