Provider Demographics
NPI:1891500997
Name:CORE PELVIC HEALTH
Entity type:Organization
Organization Name:CORE PELVIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDVIG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:605-206-4547
Mailing Address - Street 1:2822 JACKSON BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-3496
Mailing Address - Country:US
Mailing Address - Phone:605-206-4547
Mailing Address - Fax:605-204-6630
Practice Address - Street 1:2822 JACKSON BLVD STE 205
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-3496
Practice Address - Country:US
Practice Address - Phone:605-206-4547
Practice Address - Fax:605-204-6630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy