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General NPI Number Information
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NPI Number | 1801001755
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Entity Type | Organization
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Legal Business Name | KOELE FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 710 E 1ST ST
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City | TEA
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State | SD
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Zip | 57064-3209
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Country | US
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Telephone | 605-498-2273
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Fax | 605-498-2225
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Provider Business Mailing Address
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Address Line | 710 E 1ST ST
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City | TEA
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State | SD
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Zip | 57064-3209
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Country | US
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Telephone | 605-498-2273
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Fax | 605-498-2225
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Authorized Official
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Title or Position | MEMBER
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Name | DR. LAURA M. KOELE
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Credential | DC
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Telephone | 605-498-2273
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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 | 06944
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1105
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License Number State | SD
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