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ACTIVESPINE LLC

Chiropractic Providers Chiropractor

Provider NPI: 1790256188

Organization Information:
Organization Name:  ACTIVESPINE LLC
Organization is not Subpart
Authorized Official:  WAYNE R HUBER  OWNER  605-271-8277

Practice Location:
6209 S OLD VILLAGE PL  SIOUX FALLS, SD 57108-2100 US
Tel: 605-271-8277  Fax: 605-988-8130

Business Mailing Address:
6209 S OLD VILLAGE PL  SIOUX FALLS, SD 57108-2100 US
Tel: 605-271-8277  Fax: --

NPI Information:
NPI: 1790256188
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 111N00000X

Type:

Classification:



Definition:



MEDICAL JOBS SD - Page 1

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