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General NPI Number Information
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NPI Number | 1790763720
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Entity Type | Individual
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Provider Name | KIMBERLY L JURACEK DC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 02/27/2013
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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 |
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Name |
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Credential |
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Telephone |
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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 | 909
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License Number State | SD
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