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General NPI Number Information
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NPI Number | 1386883163
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Entity Type | Organization
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Legal Business Name | WATERTOWN WELLNESS AND CHIROPRACTIC
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 502 JENSON AVE SE
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City | WATERTOWN
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State | SD
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Zip | 57201-5261
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Country | US
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Telephone | 160-588-2233
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Fax |
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Provider Business Mailing Address
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Address Line | 502 JENSON AVE SE
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City | WATERTOWN
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State | SD
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Zip | 57201-5261
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Country | US
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Telephone | 160-588-2233
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | JOY C SABINASH-MILLER
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Credential | DC
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Telephone | 16058822333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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