Healthcare Provider Details

I. General information

NPI: 1609309848
Provider Name (Legal Business Name): QUALITY CARE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 S IOWA ST STE 105
MITCHELL SD
57301-3888
US

IV. Provider business mailing address

713 S IOWA ST STE 105
MITCHELL SD
57301-3888
US

V. Phone/Fax

Practice location:
  • Phone: 605-999-5537
  • Fax:
Mailing address:
  • Phone: 605-999-5537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1310
License Number StateSD

VIII. Authorized Official

Name: DR. CHAD ALAN VERMEULEN
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 605-999-5537