Healthcare Provider Details

I. General information

NPI: 1326634809
Provider Name (Legal Business Name): REDFIELD CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 N MAIN ST
REDFIELD SD
57469-1209
US

IV. Provider business mailing address

615 N MAIN ST
REDFIELD SD
57469-1209
US

V. Phone/Fax

Practice location:
  • Phone: 605-472-1405
  • Fax: 605-472-1408
Mailing address:
  • Phone: 605-472-1405
  • Fax: 605-472-1408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KATE M HARTUNG
Title or Position: CHIROPRACTIC TECH
Credential:
Phone: 605-472-1405