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General NPI Number Information
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NPI Number | 1659641017
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Entity Type | Organization
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Legal Business Name | BEAR CHIROPRACTIC, PC
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 201 NW 13TH ST SUITE 3
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City | BERESFORD
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State | SD
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Zip | 57004-1545
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Country | US
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Telephone | 605-763-8056
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Fax | 605-763-8057
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Provider Business Mailing Address
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Address Line | 201 NW 13TH ST SUITE 3
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City | BERESFORD
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State | SD
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Zip | 57004-1545
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Country | US
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Telephone | 605-763-8056
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Fax | 605-763-8057
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REBECCA L BEAR
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Credential | DC
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Telephone | 605-763-8056
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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 | 1044
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License Number State | SD
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