MEDICARE: ROGER DEAN PRILL JR.

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	743	SD

General Provider Information

NPI Number	:	1720299639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROGER DEAN PRILL JR.

Provider Business Mailing Address
First Line	:	1501 N MAIN ST
Second Line	:
City	:	MITCHELL
State	:	SD
Zip	:	57301-1017
Country	:	US
Telephone Number	:	605-996-7288
Fax Number	:	605-995-0293

Provider Business Practice Location Address
First Line	:	1501 N MAIN ST
Second Line	:
City	:	MITCHELL
State	:	SD
Zip	:	57301-1017
Country	:	US
Telephone Number	:	605-996-7288
Fax Number	:	605-995-0293

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROGER DEAN PRILL JR.
Credential	:	DC
Telephone Number	:	605-996-7288

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	02/23/2011

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Directions to “ROGER DEAN PRILL JR. ” Practice Location

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