Provider Demographics
NPI:1720273758
Name:STRAIN CHIROPRACTIC CLINIC, PROF. LLC
Entity Type:Organization
Organization Name:STRAIN CHIROPRACTIC CLINIC, PROF. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:STERZINGER
Authorized Official - Last Name:STRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-718-5720
Mailing Address - Street 1:2120 W MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-0906
Mailing Address - Country:US
Mailing Address - Phone:605-718-5720
Mailing Address - Fax:605-718-5721
Practice Address - Street 1:2120 W MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-0906
Practice Address - Country:US
Practice Address - Phone:605-718-5720
Practice Address - Fax:605-718-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD 1004111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS41396Medicare PIN