Healthcare Provider Details

I. General information

NPI: 1922130152
Provider Name (Legal Business Name): ENVIVE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 S 1ST AVE
SIOUX FALLS SD
57104-6901
US

IV. Provider business mailing address

412 S 1ST AVE
SIOUX FALLS SD
57104-6901
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-1188
  • Fax: 605-336-2677
Mailing address:
  • Phone: 605-336-1188
  • Fax: 605-336-2677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN KRISTIAN UNRUH
Title or Position: PRESIDENT
Credential: DC
Phone: 605-336-1188