Provider Demographics
NPI:1386883163
Name:WATERTOWN WELLNESS AND CHIROPRACTIC
Entity type:Organization
Organization Name:WATERTOWN WELLNESS AND CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SABINASH-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:1605-882-2333
Mailing Address - Street 1:502 JENSON AVE SE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-5261
Mailing Address - Country:US
Mailing Address - Phone:160-588-2233
Mailing Address - Fax:
Practice Address - Street 1:502 JENSON AVE SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-5261
Practice Address - Country:US
Practice Address - Phone:160-588-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WATERTOWN WELLNESS AND CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-18
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center