Provider Demographics
NPI:1760442099
Name:NEUROSURGICAL & SPINAL SURGERY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NEUROSURGICAL & SPINAL SURGERY ASSOCIATES, P.C.
Other - Org Name:PROMOTION PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:G
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-341-2424
Mailing Address - Street 1:4141 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6021
Mailing Address - Country:US
Mailing Address - Phone:605-399-9565
Mailing Address - Fax:605-399-9584
Practice Address - Street 1:4141 5TH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6021
Practice Address - Country:US
Practice Address - Phone:605-399-9565
Practice Address - Fax:605-399-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0256261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4998880OtherWELLMARK
NE100263804-00Medicaid
SD142500500OtherOWCP
SD27098OtherSANFORD HEALTH
SD27098OtherSANFORD HEALTH
SD=========OtherMEDICA
SD=========.1OtherDAKOTACARE
SD4998880OtherWELLMARK
SD=========OtherDAKOTACARE