Stardust Red Bow's National Provider Identifier (NPI) Details
Stardust Red Bow, MSW, CSW-PIP
NPI: 1578709465
Enumeration Date: 2008-12-23
Last updated: 2014-01-13
Sole Proprietor: NO
Status: active
Postal Address: 3625 5TH ST, RAPID CITY, SD
Phone: 605-718-1095
Primary Practice Address: 3625 5TH ST, RAPID CITY, SD
Practice's phone: 605-718-1095