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NPI Code Detail

MEDICARE: HARRISBURG FAMILY CHIROPRACTIC PC

MEDICARE: HARRISBURG FAMILY CHIROPRACTIC PC
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
1111N00000XChiropractor1076SD

General Provider Information

NPI Number : 1700060811
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARRISBURG FAMILY CHIROPRACTIC PC
Provider Business Mailing Address
First Line : 303 W WILLOW ST
Second Line :
City : HARRISBURG
State : SD
Zip : 57032-2004
Country : US
Telephone Number : 605-767-7463
Fax Number : 605-767-7464
Provider Business Practice Location Address
First Line : 303 W WILLOW ST
Second Line :
City : HARRISBURG
State : SD
Zip : 57032-2004
Country : US
Telephone Number : 605-767-7463
Fax Number : 605-767-7464
Authorized Official
Title or Position : CEO
Name : DR. ASHLEY BROOKS MAYLAND
Credential : DC
Telephone Number : 605-767-7463
Provider Enumeration Date : 12/26/2007
Last Update Date : 11/05/2012

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