Provider Demographics
NPI:1477030278
Name:RUNYAN, JOSIE CHRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSIE
Middle Name:CHRISTINE
Last Name:RUNYAN
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 1:1109 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1424
Mailing Address - Country:US
Mailing Address - Phone:605-642-7111
Mailing Address - Fax:
Practice Address - Street 1:9975 VALLEY VIEW RD STE M
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3526
Practice Address - Country:US
Practice Address - Phone:941-952-1087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor