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General NPI Number Information
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NPI Number | 1760577753
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Entity Type | Organization
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Legal Business Name | DAKOTA FAMILY CHIROPRACTIC OF MITCHELL PC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 708 E KAY AVE
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City | MITCHELL
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State | SD
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Zip | 57301
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Country | US
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Telephone | 605-996-2186
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Fax | 605-996-2187
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Provider Business Mailing Address
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Address Line | PO BOX 1006
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City | MITCHELL
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State | SD
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Zip | 57301-7006
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Country | US
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Telephone | 605-996-2186
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Fax | 605-996-2187
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Authorized Official
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Title or Position | OWNER
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Name | JOHN W PRUNTY
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Credential | DC
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Telephone | 605-996-2186
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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 | 976
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License Number State | SD
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