Provider Demographics
NPI: | 1952933772 |
---|---|
Name: | SEYER CHIROPRACTIC LLC |
Entity type: | Organization |
Organization Name: | SEYER CHIROPRACTIC LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIROPRACTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERRENCE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SEYER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 605-432-9561 |
Mailing Address - Street 1: | PO BOX 230 |
Mailing Address - Street 2: | |
Mailing Address - City: | MILLBANK |
Mailing Address - State: | SD |
Mailing Address - Zip Code: | 57252 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 605-432-9561 |
Mailing Address - Fax: | 605-432-9562 |
Practice Address - Street 1: | 1002 S. DAKOTA ST. STE. 101 |
Practice Address - Street 2: | |
Practice Address - City: | MILBANK |
Practice Address - State: | SD |
Practice Address - Zip Code: | 57252 |
Practice Address - Country: | US |
Practice Address - Phone: | 605-432-9561 |
Practice Address - Fax: | 605-432-9562 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-02-10 |
Last Update Date: | 2022-03-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
SD | 2000037 | Medicaid |