Provider Demographics
NPI:1659641017
Name:BEAR CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:BEAR CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-763-8056
Mailing Address - Street 1:201 NW 13TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BERESFORD
Mailing Address - State:SD
Mailing Address - Zip Code:57004-1545
Mailing Address - Country:US
Mailing Address - Phone:605-763-8056
Mailing Address - Fax:605-763-8057
Practice Address - Street 1:201 NW 13TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:BERESFORD
Practice Address - State:SD
Practice Address - Zip Code:57004-1545
Practice Address - Country:US
Practice Address - Phone:605-763-8056
Practice Address - Fax:605-763-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty