Provider Demographics
NPI:1730245994
Name:UNDERWOOD CHIROPRACTIC PC
Entity type:Organization
Organization Name:UNDERWOOD CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:TEETS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-442-3900
Mailing Address - Street 1:302 2ND ST
Mailing Address - Street 2:PO BOX 67
Mailing Address - City:UNDERWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58576
Mailing Address - Country:US
Mailing Address - Phone:701-442-3900
Mailing Address - Fax:701-442-3901
Practice Address - Street 1:302 2ND ST
Practice Address - Street 2:
Practice Address - City:UNDERWOOD
Practice Address - State:ND
Practice Address - Zip Code:58576
Practice Address - Country:US
Practice Address - Phone:701-442-3900
Practice Address - Fax:701-442-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND774111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty