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General NPI Number Information
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NPI Number | 1598737173
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Entity Type | Organization
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Legal Business Name | MITCHELL CHIROPRACTIC & ACUPUNCTURE CENTER, P.C.
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 501 W HAVENS ST
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City | MITCHELL
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State | SD
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Zip | 57301-4334
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Country | US
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Telephone | 605-996-1078
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Fax | 605-996-3703
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Provider Business Mailing Address
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Address Line | 501 W HAVENS ST
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City | MITCHELL
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State | SD
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Zip | 57301-4334
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Country | US
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Telephone | 605-996-1078
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Fax | 605-996-3703
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Authorized Official
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Title or Position | CA
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Name | MRS. SANDY K HANSSEN
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Credential |
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Telephone | 605-996-1078
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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 | 862
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License Number State | SD
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