Organization
KOSTELECKY CHIROPRACTIC CLINIC INC
Active
Other names
CHIROPRACTIC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON MICHAEL KOSTELECKY D.C. (OWNER)
(701) 225-3536
Entity
Organization
Contact information
Practice address
383 15TH ST W, DICKINSON, ND 58601-3017
(701) 225-3536
Mailing address
383 15TH ST W, DICKINSON, ND 58601-3017
(701) 225-3536
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
555
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17849
—
ND
01
—
KOS 18901
BLUE CROSS BLUE SHIELD
ND
Enumeration date
02/12/2007
Last updated
04/20/2011
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