Provider Demographics
NPI:1255526620
Name:DORSETT CHIROPRACTIC CENTER, PROF. LLC
Entity type:Organization
Organization Name:DORSETT CHIROPRACTIC CENTER, PROF. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DORSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-345-6222
Mailing Address - Street 1:511 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:SD
Mailing Address - Zip Code:57274-1718
Mailing Address - Country:US
Mailing Address - Phone:605-345-6222
Mailing Address - Fax:605-345-6224
Practice Address - Street 1:511 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:SD
Practice Address - Zip Code:57274-1718
Practice Address - Country:US
Practice Address - Phone:605-345-6222
Practice Address - Fax:605-345-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD41377Medicare PIN