Provider Demographics
NPI:1659418960
Name:CORNERSTONE THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:CORNERSTONE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:BICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-234-1287
Mailing Address - Street 1:200 PAUL GUST RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325-1031
Mailing Address - Country:US
Mailing Address - Phone:605-234-1287
Mailing Address - Fax:
Practice Address - Street 1:200 PAUL GUST RD
Practice Address - Street 2:SUITE 109
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-1031
Practice Address - Country:US
Practice Address - Phone:605-234-1287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4996062OtherGROUP WELLMARK
SD41471Medicare ID - Type UnspecifiedGROUP MEDICARE