Healthcare Provider Details

I. General information

NPI: 1164599874
Provider Name (Legal Business Name): STUDELSKA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 COMMERCE ST. SUITE 102
MITCHELL SD
57301
US

IV. Provider business mailing address

PO BOX 923
MITCHELL SD
57301-0923
US

V. Phone/Fax

Practice location:
  • Phone: 605-996-0191
  • Fax:
Mailing address:
  • Phone: 605-996-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number981
License Number StateSD

VIII. Authorized Official

Name: DR. REBECCA ANN STUDELSKA
Title or Position: CHIROPRACTIC PHYSICIAN OWNER
Credential: D.C.
Phone: 605-996-0191