Individual
DR. WILLIAM C BLICKENSDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2326 CANYON LAKE DR, STE 7, RAPID CITY, SD 57702-2913
(605) 343-1113
(605) 342-8424
Mailing address
2326 CANYON LAKE DR, STE 7, RAPID CITY, SD 57702-2913
(605) 343-1113
(605) 342-8424
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
734
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006076
BLUE CROSS BLUE SHIELD
SD
05
—
7603190
—
SD
01
—
S6076
MEDICARE B
SD
Enumeration date
07/19/2006
Last updated
08/25/2011
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