Provider Demographics
NPI:1205837580
Name:JUEL, ALAN P (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:P
Last Name:JUEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 W MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-1707
Mailing Address - Country:US
Mailing Address - Phone:605-348-5134
Mailing Address - Fax:605-348-6420
Practice Address - Street 1:3202 W MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-1707
Practice Address - Country:US
Practice Address - Phone:605-348-5134
Practice Address - Fax:605-348-6420
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7602870Medicaid
SDS86560Medicare PIN
T66576Medicare UPIN