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General NPI Number Information
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NPI Number | 1609309848
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Entity Type | Organization
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Legal Business Name | QUALITY CARE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 04/05/2017
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Provider Practice Location Address
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Address Line | 713 S IOWA ST STE 105
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City | MITCHELL
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State | SD
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Zip | 57301-3888
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Country | US
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Telephone | 605-999-5537
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Fax |
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Provider Business Mailing Address
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Address Line | 713 S IOWA ST STE 105
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City | MITCHELL
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State | SD
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Zip | 57301-3888
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Country | US
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Telephone | 605-999-5537
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. CHAD ALAN VERMEULEN
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Credential | D.C.
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Telephone | 605-999-5537
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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 | 1310
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License Number State | SD
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