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Organization
TIESZEN CHIROPRACTIC CLINIC, P.C.
Active
Organization
TIESZEN CHIROPRACTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD LANE TIESZEN D.C. (PRESIDENT)
(605) 987-5577
Entity
Organization
Contact information
Practice address
128 N DAKOTA ST, CANTON, SD 57013-1832
(605) 987-5577
Mailing address
128 N DAKOTA ST, PO BOX 224, CANTON, SD 57013-1832
(605) 987-5577
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
912
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7600460
—
SD
Enumeration date
03/23/2007
Last updated
07/25/2012
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