- Obstetricians & Gynecologists, Spearfish - Ob-Gyn Doctors, Physicians & Surgeons (Obstetrics & Gynecology)
- Occupational Health Care Professionals, Spearfish
- Occupational Therapy, Spearfish - Occupational Health Specialists
- Off Road Vehicles, Spearfish
- Off Road Vehicles Parts & Accessories, Spearfish
- Office Supplies, Equipment & Office Furniture Stores, Spearfish
- Oil Change & Lubrication, Spearfish - Auto Oil & Quick Lube
- Open Bible Church, Spearfish
- Ophthalmologists, Spearfish - Eye Doctors, Physicians & Surgeons (Ophthalmology)
- Optical Goods Manufacturers, Spearfish
- Optical Stores - Eyeglasses, Lenses & Sunglasses, Spearfish
- Opticians, Spearfish
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- Optometrists, Spearfish - Eye Doctors, Physicians & Surgeons (Optometry)
- Ornamental Nursery, Spearfish
- Ornamental Nursery Services, Spearfish
- Orthodontist, Spearfish - Teeth Straightening, Invisalign & Dental Braces
- Orthopedists, Spearfish - Orthopedic Surgery Doctors, Physicians & Surgeons
- Other Building Materials & Supplies, Spearfish
- Other Lodging, Spearfish
- Outdoor Advertising & Billboard, Spearfish
- Outdoor Equipment & Accessories, Spearfish
- Outdoor Furniture & Patio Furniture, Spearfish - Garden Furniture Stores
- Oxygen & Respiratory Equipment & Supplies, Spearfish - Oxygen Concentrator, Tank, Machine, etc
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