Provider Demographics
NPI:1154463347
Name:CHEESEMAN, DEBRA M (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:M
Last Name:CHEESEMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 NORTH MAIN ST
Mailing Address - Street 2:PO BOX 59
Mailing Address - City:SALEM
Mailing Address - State:SD
Mailing Address - Zip Code:57058
Mailing Address - Country:US
Mailing Address - Phone:605-425-2754
Mailing Address - Fax:
Practice Address - Street 1:221 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:SD
Practice Address - Zip Code:57058
Practice Address - Country:US
Practice Address - Phone:605-425-2754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS41286Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
SD41285Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE