Provider Demographics
NPI:1174713507
Name:ALTERNATIVE BACK CARE CLINIC, PC
Entity type:Organization
Organization Name:ALTERNATIVE BACK CARE CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BUNKERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-335-7744
Mailing Address - Street 1:229 W 39TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-5700
Mailing Address - Country:US
Mailing Address - Phone:605-335-7744
Mailing Address - Fax:605-373-0343
Practice Address - Street 1:229 W 39TH ST STE 300
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-5700
Practice Address - Country:US
Practice Address - Phone:605-335-7744
Practice Address - Fax:605-373-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD810111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDU46401Medicare UPIN
SDS3582Medicare PIN