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Individual
PAUL WILLIAM THIELEN
Active
Individual
PAUL WILLIAM THIELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
703
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003416
BLUE CROSS BLUE SHIELD
SD
01
—
0823
HEALTH SERVICE MANAGEMENT
—
05
—
12612
—
ND
01
—
23433
SIOUX VALLEY HEALTH
SD
01
—
390728700
MEDICAL ASSISTANCE
MN
01
—
3C880TH
BLUE CROSS BLUE SHIELD
MN
01
—
410131
MEDICA
—
05
—
7602742
—
SD
Enumeration date
08/31/2006
Last updated
11/06/2012
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