Provider Demographics
NPI:1083153415
Name:BABCOCK FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BABCOCK FAMILY CHIROPRACTIC, LLC
Other - Org Name:BLEDSOE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BABCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-380-3517
Mailing Address - Street 1:221 6TH AVE SE STE 1
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4326
Mailing Address - Country:US
Mailing Address - Phone:605-229-1212
Mailing Address - Fax:605-229-4440
Practice Address - Street 1:221 6TH AVE SE STE 1
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4326
Practice Address - Country:US
Practice Address - Phone:605-229-1212
Practice Address - Fax:605-229-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty