Provider Demographics
NPI:1992785885
Name:NATURAL ARTS CHIROPRACTIC & ACUPUNCTURE PROF LLC
Entity type:Organization
Organization Name:NATURAL ARTS CHIROPRACTIC & ACUPUNCTURE PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-373-9090
Mailing Address - Street 1:2200 W 49TH ST #106
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6550
Mailing Address - Country:US
Mailing Address - Phone:605-373-9090
Mailing Address - Fax:605-336-0771
Practice Address - Street 1:2200 W 49TH ST STE 106
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6550
Practice Address - Country:US
Practice Address - Phone:605-373-9090
Practice Address - Fax:605-336-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD952111N00000X
SD950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0040563OtherBC/BS GROUP #
SD40563Medicare PIN