BLAKE WADSWORTH

RAPID CITY, SD
NPI1417699919
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: SD  17531)
Enumeration Date2022-04-13
Last Update Date2025-07-23
Business Address
BLAKE WADSWORTH
2526 ELDERBERRY BOULEVARD
RAPID CITY, SD 57703
Phone number: 605-755-1000
Mailing Address
BLAKE WADSWORTH
2526 ELDERBERRY BOULEVARD
RAPID CITY, SD 57703
Phone number: