Organization
SOUTHRIDGE CHIROPRACTIC PC
Active
Other names
Southridge Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERI LEE TEN BROEK DC (OWNER/DOCTOR)
(701) 258-8388
Entity
Organization
Contact information
Practice address
425 S 7TH ST, BISMARCK, ND 58504-5801
(701) 258-8388
(701) 258-8788
Mailing address
425 S 7TH ST, BISMARCK, ND 58504-5801
(701) 258-8388
(701) 258-8788
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17897
—
ND
01
—
572001
BCBS OF ND
ND
Enumeration date
08/12/2006
Last updated
08/23/2007
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