Provider Demographics
NPI:1376634121
Name:EXCEL CHIROPRACTIC & REHABILITATION PC
Entity Type:Organization
Organization Name:EXCEL CHIROPRACTIC & REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:KENDALL
Authorized Official - Last Name:TOUNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-332-9235
Mailing Address - Street 1:4309 S RACKET DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2257
Mailing Address - Country:US
Mailing Address - Phone:605-332-9235
Mailing Address - Fax:605-332-6642
Practice Address - Street 1:4309 S RACKET DR STE 1
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2257
Practice Address - Country:US
Practice Address - Phone:605-332-9235
Practice Address - Fax:605-332-6642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7601920Medicaid
SD100050Medicare ID - Type Unspecified
SD7601920Medicaid