Individual
BRUCE EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHIROPRACTOR
Contact information
Practice address
4627 W HOMEFIELD DR, SIOUX FALLS, SD 57106-3511
(605) 336-2010
(605) 336-0249
Mailing address
4627 W HOMEFIELD DR, SIOUX FALLS, SD 57106-3511
(605) 336-2010
(605) 336-0249
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
602
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20860
SIOUX VALLEY HEALTH PLAN
SD
01
—
248015
MIDLAND
—
01
—
4994546
WELLMARK
SD
05
—
7600882
—
SD
Enumeration date
01/18/2006
Last updated
11/06/2007
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