Healthcare Provider Details

I. General information

NPI: 1144187832
Provider Name (Legal Business Name): MADDILYN RAE DEGROOT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 275
PLATTE SD
57369-0275
US

IV. Provider business mailing address

PO BOX 275
PLATTE SD
57369-0275
US

V. Phone/Fax

Practice location:
  • Phone: 605-680-2219
  • Fax:
Mailing address:
  • Phone: 605-680-2219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1530
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: