Provider Demographics
NPI:1275503401
Name:KRAMER, THERESA L (DC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:KRAMER
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 1:301 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRIPP
Mailing Address - State:SD
Mailing Address - Zip Code:57376
Mailing Address - Country:US
Mailing Address - Phone:605-935-6116
Mailing Address - Fax:605-935-6118
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TRIPP
Practice Address - State:SD
Practice Address - Zip Code:57376
Practice Address - Country:US
Practice Address - Phone:605-935-6116
Practice Address - Fax:605-935-6118
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD885111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS41846Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
SDU69544Medicare UPIN
SDS41848Medicare ID - Type Unspecified