Provider Demographics
NPI:1447571724
Name:EKLUND CHIROPRACTIC PC
Entity Type:Organization
Organization Name:EKLUND CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EKLUND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-717-9314
Mailing Address - Street 1:526 W JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1909
Mailing Address - Country:US
Mailing Address - Phone:605-717-9314
Mailing Address - Fax:
Practice Address - Street 1:526 W JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1909
Practice Address - Country:US
Practice Address - Phone:605-717-9314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty