MEDICARE: FAMILY CHIROPRACTIC CENTER, 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
1	111N00000X	Chiropractor	1072	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	:	1770766727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHIROPRACTIC CENTER, PC

Provider Business Mailing Address
First Line	:	300 S THOMPSON AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-2015
Country	:	US
Telephone Number	:	605-338-1895
Fax Number	:	605-338-8282

Provider Business Practice Location Address
First Line	:	300 S THOMPSON AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-2015
Country	:	US
Telephone Number	:	605-338-1895
Fax Number	:	605-338-8282

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH DONALD COTTON
Credential	:	D.C.
Telephone Number	:	605-338-1895

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	12/13/2007

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