Provider Demographics
NPI:1942313093
Name:REED, SUSAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:REED
Suffix:
Gender:F
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:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-0345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:811 LABARGE CT
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-4718
Practice Address - Country:US
Practice Address - Phone:605-645-0657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD836111N00000X
MN4406111N00000X
CO5461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0165546Medicaid
SD4995806OtherBLUECROSS/BLUE SHIELD
SD7600412Medicaid
SD4995806OtherBLUECROSS/BLUE SHIELD
S41583Medicare ID - Type Unspecified