Provider Demographics
NPI:1063127280
Name:LAUTT, DYLAN (DC)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:
Last Name:LAUTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 S APPOLLONIA CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-7548
Mailing Address - Country:US
Mailing Address - Phone:605-370-1575
Mailing Address - Fax:
Practice Address - Street 1:3301 E 26TH ST STE 109
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4180
Practice Address - Country:US
Practice Address - Phone:605-339-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor