Provider Demographics
NPI:1730481466
Name:KONSTANT CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:KONSTANT CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:KONSTANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-881-3397
Mailing Address - Street 1:1725 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2126
Mailing Address - Country:US
Mailing Address - Phone:605-338-6411
Mailing Address - Fax:
Practice Address - Street 1:1725 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2126
Practice Address - Country:US
Practice Address - Phone:605-338-6411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD2000849Medicaid
SD2000849Medicaid