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Individual

DR. BRIAN CLAY BAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1 5TH ST SE, WATERTOWN, SD 57201-3778
(605) 882-4252
Mailing address
1129 4TH AVE SE, WATERTOWN, SD 57201-4577
(605) 753-2050

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
687
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7600120
SD
Enumeration date
02/07/2007
Last updated
07/08/2007
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