Provider Demographics
NPI:1932286036
Name:GITZEN, JOSEPH MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:GITZEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-2322
Mailing Address - Country:US
Mailing Address - Phone:605-256-4752
Mailing Address - Fax:605-256-4752
Practice Address - Street 1:414 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-2322
Practice Address - Country:US
Practice Address - Phone:605-256-4752
Practice Address - Fax:605-256-4752
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD248609OtherMIDLANDS CHOICE
SD13734OtherAVERA
SD4994403OtherWELLMARK
SD7604420Medicaid
SDC1066/ 9232761OtherDAKOTACARE
SD13734OtherAVERA