Provider Demographics
NPI:1871914994
Name:RUSHMORE FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:RUSHMORE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-716-0646
Mailing Address - Street 1:1107 MOUNT RUSHMORE RD
Mailing Address - Street 2:STE 2
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8200
Mailing Address - Country:US
Mailing Address - Phone:605-716-0646
Mailing Address - Fax:605-716-0645
Practice Address - Street 1:1107 MOUNT RUSHMORE RD
Practice Address - Street 2:STE 2
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8200
Practice Address - Country:US
Practice Address - Phone:605-716-0646
Practice Address - Fax:605-716-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty