=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437117397
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA ANN STUDELSKA D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2006
-----------------------------------------------------
Last Update Date | 10/01/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 950 COMMERCE ST. SUITE 102
-----------------------------------------------------
City | MITCHELL
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-996-0191
-----------------------------------------------------
Fax | 605-996-0716
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 923
-----------------------------------------------------
City | MITCHELL
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57301-0923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-996-0191
-----------------------------------------------------
Fax | 605-996-0716
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 981
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------