| NPI | 1346345840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE JON HAGEN Owner 605-361-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SD 714) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1351) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-09-28 |