Healthcare Provider Details

I. General information

NPI: 1144697509
Provider Name (Legal Business Name): INTEGRATED CHIROPRACTIC AND REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W. 57TH STREET SUITE 131
SIOUX FALLS SD
57108
US

IV. Provider business mailing address

4301 W. 57TH STREET SUITE 131
SIOUX FALLS SD
57108
US

V. Phone/Fax

Practice location:
  • Phone: 605-368-0195
  • Fax: 605-534-7022
Mailing address:
  • Phone: 605-368-0195
  • Fax: 605-534-7022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1193
License Number StateSD

VIII. Authorized Official

Name: DR. GALEN R STOLP
Title or Position: OWNER/PROVIDER
Credential: DC
Phone: 605-977-2055