MEDICARE: SOUTHERN HILLS CHIROPRACTIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	990	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350056029	OTHER	SD	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952594962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN HILLS CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	1245 SHERMAN ST
Second Line	:
City	:	HOT SPRINGS
State	:	SD
Zip	:	57747-1465
Country	:	US
Telephone Number	:	605-745-6262
Fax Number	:	605-745-6256

Provider Business Practice Location Address
First Line	:	1245 SHERMAN ST
Second Line	:
City	:	HOT SPRINGS
State	:	SD
Zip	:	57747-1465
Country	:	US
Telephone Number	:	605-745-6262
Fax Number	:	605-745-6256

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NATHAN T RITTERBUSH
Credential	:	D.C.
Telephone Number	:	605-745-6262

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	08/21/2008

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