Organization
TRI-STATE CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS J LARSON DC (OWNER)
(605) 892-4845
Entity
Organization
Contact information
Practice address
1515 5TH AVE, SUITE 101, BELLE FOURCHE, SD 57717-6031
(605) 892-4845
Mailing address
1515 5TH AVE, SUITE 101, BELLE FOURCHE, SD 57717-6031
(605) 892-4845
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
689
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7602992
—
SD
Enumeration date
09/03/2008
Last updated
09/03/2008
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