Provider Demographics
NPI:1851714794
Name:VITALITY CHIROPRACTIC OF THE BLACK HILLS, P.C.
Entity Type:Organization
Organization Name:VITALITY CHIROPRACTIC OF THE BLACK HILLS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-716-4455
Mailing Address - Street 1:750 SHERIDAN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2551
Mailing Address - Country:US
Mailing Address - Phone:605-716-4455
Mailing Address - Fax:605-716-5433
Practice Address - Street 1:750 SHERIDAN LAKE RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2551
Practice Address - Country:US
Practice Address - Phone:605-716-4455
Practice Address - Fax:605-716-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty