Provider Demographics
NPI:1831963669
Name:THE BONESETTER CHIROPRACTIC, PROF LLC
Entity type:Organization
Organization Name:THE BONESETTER CHIROPRACTIC, PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:STOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-661-3427
Mailing Address - Street 1:215 MULBERRY ST STE 9
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4441
Mailing Address - Country:US
Mailing Address - Phone:605-401-5701
Mailing Address - Fax:
Practice Address - Street 1:215 MULBERRY ST STE 9
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-4441
Practice Address - Country:US
Practice Address - Phone:605-401-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty