Basic Information
| Provider Information | |||||||||
| NPI: | 1013228402 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLE | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 353 FAIRMONT BLVD | ||||||||
| Address2: | |||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577017350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072842511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2805 5TH ST | ||||||||
| Address2: | 100 | ||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577017306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057555700 | ||||||||
| FaxNumber: | 6057555701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2010 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | TEP 6392 | NE | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208100000X | 105686 | MN | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 54608 | MN | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 9491 | SD | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.