MEDICARE: DR. RICK DANIEL ODLAND D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	946	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013069947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICK DANIEL ODLAND D.C.

Provider Business Mailing Address
First Line	:	3600 S MARION RD STE 101
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-1349
Country	:	US
Telephone Number	:	605-361-2500
Fax Number	:	605-362-1930

Provider Business Practice Location Address
First Line	:	3600 S MARION RD STE 101
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-1349
Country	:	US
Telephone Number	:	605-361-2500
Fax Number	:	605-362-1930

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	11/28/2018

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