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NPI 1346319910

NPI 1346319910 : REBECCA LYNN BEAR D.C. : BERESFORD, SD

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General NPI Number Information
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    NPI Number           |    1346319910
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA LYNN BEAR D.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/07/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    201 NW 13TH ST SUITE 3
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    City                 |    BERESFORD
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    State                |    SD
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    Zip                  |    57004-1545
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    Country              |    US
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    Telephone            |    605-763-8056
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    Fax                  |    605-763-8057
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Provider Business Mailing Address
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    Address Line         |    201 NW 13TH ST SUITE 3
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    City                 |    BERESFORD
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    State                |    SD
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    Zip                  |    57004-1545
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    Country              |    US
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    Telephone            |    605-763-8056
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    Fax                  |    605-763-8057
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    1044
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    License Number State |    SD
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