Provider Demographics
NPI:1053504241
Name:NEW LEAF CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:NEW LEAF CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HULS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-371-4611
Mailing Address - Street 1:2909 E 57TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-4502
Mailing Address - Country:US
Mailing Address - Phone:605-371-4611
Mailing Address - Fax:
Practice Address - Street 1:2909 E 57TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-4502
Practice Address - Country:US
Practice Address - Phone:605-371-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty