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General NPI Number Information
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NPI Number | 1548670169
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Entity Type | Organization
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Legal Business Name | HOUDESHELL CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 318 MAIN AVE SUITE #1
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City | PLATTE
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State | SD
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Zip | 57369-2120
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Country | US
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Telephone | 605-337-3102
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Fax | 605-337-3104
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Provider Business Mailing Address
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Address Line | 318 MAIN AVE STE 1 PO BOX 284
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City | PLATTE
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State | SD
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Zip | 57369-2120
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Country | US
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Telephone | 605-337-3102
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Fax | 605-337-3104
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. CALLIE BETH HOUDESHELL
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Credential | D.C.
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Telephone | 605-337-3102
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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 | 1207
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License Number State | SD
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