Provider Demographics
NPI:1447776380
Name:VANCE, CHANTEL (DC)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:VANCE
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 QUINCY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8230
Mailing Address - Country:US
Mailing Address - Phone:605-791-0868
Mailing Address - Fax:605-791-1102
Practice Address - Street 1:623 QUINCY ST STE 101
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8230
Practice Address - Country:US
Practice Address - Phone:605-791-0868
Practice Address - Fax:605-791-1102
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor