Provider Demographics
NPI:1043866114
Name:KEISER CHIROPRACTIC PROF., LLC
Entity Type:Organization
Organization Name:KEISER CHIROPRACTIC PROF., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-271-0119
Mailing Address - Street 1:4009 W 49TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5221
Mailing Address - Country:US
Mailing Address - Phone:605-271-0119
Mailing Address - Fax:
Practice Address - Street 1:4009 W 49TH ST STE 310
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106
Practice Address - Country:US
Practice Address - Phone:605-271-0119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty