Provider Demographics
NPI:1306487624
Name:BERESFORD FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:BERESFORD FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGGENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-763-8056
Mailing Address - Street 1:504 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BERESFORD
Mailing Address - State:SD
Mailing Address - Zip Code:57004-1503
Mailing Address - Country:US
Mailing Address - Phone:605-763-8056
Mailing Address - Fax:605-763-8056
Practice Address - Street 1:504 N 16TH ST
Practice Address - Street 2:
Practice Address - City:BERESFORD
Practice Address - State:SD
Practice Address - Zip Code:57004-1503
Practice Address - Country:US
Practice Address - Phone:605-763-8056
Practice Address - Fax:605-763-8056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty