Provider Demographics
NPI:1346785490
Name:CHIROSPORT DELL RAPIDS PC
Entity Type:Organization
Organization Name:CHIROSPORT DELL RAPIDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-334-6656
Mailing Address - Street 1:410 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DELL RAPIDS
Mailing Address - State:SD
Mailing Address - Zip Code:57022
Mailing Address - Country:US
Mailing Address - Phone:605-334-6656
Mailing Address - Fax:605-271-7616
Practice Address - Street 1:410 W 4TH ST
Practice Address - Street 2:
Practice Address - City:DELL RAPIDS
Practice Address - State:SD
Practice Address - Zip Code:57022
Practice Address - Country:US
Practice Address - Phone:605-334-6656
Practice Address - Fax:605-271-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty