Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 810 | SD |
NPI | 1205817004 |
---|---|
Provider Name | Dr. Paul Joseph Bunkers |
First Address | Sioux Falls, SD 57105-5700 |
Second Address | Sioux Falls, SD 57105-5700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U46401 | (02) | SD |