Ryan Brucker I

Individual provider Active NPI Case Manager/Care Coordinator · Rapid City, SD

NPI 1740600642 · NPPES record last updated Apr 18, 2014

Key facts

NPI
1740600642
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
350 Elk St
Rapid City, SD 57701-7351
Phone
(160) 534-3726
Fax
(160) 534-2369
NPI assigned
Apr 18, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

350 Elk St
Rapid City, SD 57701-7351

Mailing address

111 North St
Rapid City, SD 57701-1163
Phone (160) 534-3065

Other providers in Rapid City, SD

All providers in Rapid City, SD · Case Manager/Care Coordinator in South Dakota

Sources for this page

Verify at the official NPI Registry.