Provider Demographics
NPI:1396050373
Name:HORACE FAMILY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:HORACE FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:SUNDBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-799-8894
Mailing Address - Street 1:534 N MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:HORACE
Mailing Address - State:ND
Mailing Address - Zip Code:58047
Mailing Address - Country:US
Mailing Address - Phone:701-799-8894
Mailing Address - Fax:
Practice Address - Street 1:534 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:HORACE
Practice Address - State:ND
Practice Address - Zip Code:58047-4640
Practice Address - Country:US
Practice Address - Phone:701-799-8894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty