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General NPI Number Information
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NPI Number | 1932220217
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Entity Type | Organization
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Legal Business Name | CAMPBELL CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 118 GATEWAY DR
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City | N. SIOUX CITY
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State | SD
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Zip | 57049
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Country | US
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Telephone | 605-232-3833
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Fax | 605-232-5255
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Provider Business Mailing Address
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Address Line | PO BOX 1427
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City | N SIOUX CITY
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State | SD
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Zip | 57049-1427
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Country | US
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Telephone | 605-232-3833
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Fax | 605-232-5255
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN JON CAMPBELL
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Credential | DC
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Telephone | 605-232-3833
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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 | 838
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License Number State | SD
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