Organization
CLAY CHIROPRACTIC CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLA J KNUTSON DC (PRESIDENT)
(605) 763-8081
Entity
Organization
Contact information
Practice address
111 E MAIN ST, BERESFORD, SD 57004-1818
(605) 763-8081
(605) 763-8181
Mailing address
111 E MAIN ST, PO BOX 506, BERESFORD, SD 57004-1818
(605) 763-8081
(605) 763-8181
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
951
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008095
WELLMARK PROVIDER NUMBER
SD
01
—
14395
SANFORD PROV. NUMBER
SD
05
—
7601360
—
SD
01
—
8095
MEDICARE ID-TYPE UNSPECIFIED
SD
Enumeration date
01/30/2012
Last updated
01/30/2012
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