Provider Demographics
NPI:1487839114
Name:FAMILY CHIROPRACTIC HEALTH CLINIC PC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC HEALTH CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-348-5647
Mailing Address - Street 1:610 EAST BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2902
Mailing Address - Country:US
Mailing Address - Phone:605-348-5647
Mailing Address - Fax:605-721-3299
Practice Address - Street 1:610 EAST BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2902
Practice Address - Country:US
Practice Address - Phone:605-348-5647
Practice Address - Fax:605-721-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD#786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS2885Medicare PIN
SDS41334Medicare PIN