Provider Demographics
NPI:1952334013
Name:HOWARD PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:HOWARD PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MENTELE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:605-772-2131
Mailing Address - Street 1:131 SOUTH MAIN ST.
Mailing Address - Street 2:PO BOX 39
Mailing Address - City:HOWARD
Mailing Address - State:SD
Mailing Address - Zip Code:57349
Mailing Address - Country:US
Mailing Address - Phone:605-772-2131
Mailing Address - Fax:701-772-2041
Practice Address - Street 1:131 SOUTH MAIN ST.
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:SD
Practice Address - Zip Code:57349
Practice Address - Country:US
Practice Address - Phone:605-772-2131
Practice Address - Fax:605-772-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy