Provider Demographics
NPI:1669971685
Name:RAPID CITY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:RAPID CITY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ARIELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOVERIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-646-3818
Mailing Address - Street 1:324 FREIHEIT LN
Mailing Address - Street 2:
Mailing Address - City:BOX ELDER
Mailing Address - State:SD
Mailing Address - Zip Code:57719-7001
Mailing Address - Country:US
Mailing Address - Phone:605-391-1433
Mailing Address - Fax:
Practice Address - Street 1:610 EAST BLVD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2902
Practice Address - Country:US
Practice Address - Phone:605-646-3818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty