Provider Demographics
NPI:1174586887
Name:KLEINJAN CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:KLEINJAN CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHULTZ-NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-692-4325
Mailing Address - Street 1:1204 MAIN AVE S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-3839
Mailing Address - Country:US
Mailing Address - Phone:605-692-4325
Mailing Address - Fax:605-692-2929
Practice Address - Street 1:1204 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-3839
Practice Address - Country:US
Practice Address - Phone:605-692-4325
Practice Address - Fax:605-301-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7600564Medicaid
SD7600564Medicaid