Individual
JEFFREY BLAINE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
434 S KIWANIS AVE, SUITE A, SIOUX FALLS, SD 57104-3710
(605) 332-7706
(605) 332-2430
Mailing address
434 S KIWANIS AVE, SUITE A, SIOUX FALLS, SD 57104-3710
(605) 332-7706
(605) 332-2430
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1099
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004329
BC/BS
SD
01
—
29C03RA
BC/BS
MN
05
—
7603990
—
SD
Enumeration date
12/04/2006
Last updated
12/04/2007
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