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Individual

CLAY STUART RUNYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1109 MAIN ST, SPEARFISH, SD 57783-1424
(605) 642-7111
(605) 644-1334
Mailing address
1109 MAIN ST, SPEARFISH, SD 57783-1424
(605) 642-7111
(605) 644-1334

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
744
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0080135
BCBS WELLMARK
SD
05
7603220
SD
Enumeration date
04/04/2007
Last updated
07/08/2007
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