Provider Demographics
NPI:1720355589
Name:PARHAM CHIROPRACTIC PC
Entity Type:Organization
Organization Name:PARHAM CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:PARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-335-3008
Mailing Address - Street 1:2500 W 46TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6507
Mailing Address - Country:US
Mailing Address - Phone:605-335-3008
Mailing Address - Fax:605-335-3107
Practice Address - Street 1:2500 W 46TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6507
Practice Address - Country:US
Practice Address - Phone:605-335-3008
Practice Address - Fax:605-335-3107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD926111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty