Provider Demographics
NPI:1336370378
Name:SRSTKA, JOSHUA R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:R
Last Name:SRSTKA
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:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:ARMOUR
Mailing Address - State:SD
Mailing Address - Zip Code:57313-0128
Mailing Address - Country:US
Mailing Address - Phone:605-724-2004
Mailing Address - Fax:
Practice Address - Street 1:622 MAIN AVENUE
Practice Address - Street 2:
Practice Address - City:ARMOUR
Practice Address - State:SD
Practice Address - Zip Code:57313
Practice Address - Country:US
Practice Address - Phone:605-724-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1185111N00000X
IDCHIA-1369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor