Organization
CLARK FAMILY CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHN BABCOCK D.C. (DOCTOR OF CHIROPRACTIC)
(605) 532-3360
Entity
Organization
Contact information
Practice address
101 N COMMERCIAL ST, CLARK, SD 57225-1523
(605) 532-3360
(605) 532-1363
Mailing address
101 N COMMERCIAL ST, CLARK, SD 57225-1523
(605) 532-3360
(605) 532-1363
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1280
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S110500
MEDICARE PTAN
SD
Enumeration date
11/21/2016
Last updated
01/05/2017
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