Individual
DR. TRACEY LYNNE KRUCKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5015 S WESTERN AVE STE 160, SIOUX FALLS, SD 57108-5025
(605) 271-8160
(605) 271-8186
Mailing address
5015 S WESTERN AVE STE 160, SIOUX FALLS, SD 57108-5025
(605) 271-8160
(605) 271-8162
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1339
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1339
STATE LICENSE
SD
01
—
1801166889
NPI
SD
01
—
LICENSE
1339
SD
Enumeration date
12/30/2013
Last updated
10/05/2020
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