Provider Demographics
NPI:1306173729
Name:PASCOE CHIROPRACTIC, PROF LLC
Entity type:Organization
Organization Name:PASCOE CHIROPRACTIC, PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-340-9163
Mailing Address - Street 1:515 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-5356
Mailing Address - Country:US
Mailing Address - Phone:605-274-6436
Mailing Address - Fax:605-275-4111
Practice Address - Street 1:515 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-5356
Practice Address - Country:US
Practice Address - Phone:605-274-6436
Practice Address - Fax:605-275-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty