Provider Demographics
NPI:1801825989
Name:FOUR HILLS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:FOUR HILLS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAKEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-274-1900
Mailing Address - Street 1:3220 W 57TH ST
Mailing Address - Street 2:STE 100A
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3145
Mailing Address - Country:US
Mailing Address - Phone:605-274-1900
Mailing Address - Fax:605-275-0625
Practice Address - Street 1:3220 W 57TH ST
Practice Address - Street 2:STE 100A
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3145
Practice Address - Country:US
Practice Address - Phone:605-274-1900
Practice Address - Fax:605-275-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty