Ivan J Ortman, DC
Individual provider Active NPI Chiropractor · Canistota, SD
NPI 1366486557 · NPPES record last updated Sep 15, 2011
Key facts
- NPI
- 1366486557
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 556 (SD)
- Practice address
- 209 W Main
Canistota, SD 57012 - Phone
- (605) 296-3431
- Fax
- (605) 296-3565
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 556 | SD | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 556 | SD | Yes |
Addresses
Primary practice location
209 W Main
Canistota, SD 57012
Mailing address
PO Box 157
Canistota, SD 57012-0157
Phone (605) 296-3431
Other providers in Canistota, SD
- Alyssa Lux
- Daniel Michael Novak
- Ortman Clinic
- Charles E Ortman
- Derrick John Ortman
- Jay W Ortman
- Ryan T Ortman
- Tom R Ortman
- Wayne H Ortman
- Abbey Taylor
All providers in Canistota, SD · Chiropractor in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.