Provider Demographics
NPI:1689811937
Name:KRYSL, NICHOLAS J (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:J
Last Name:KRYSL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-8128
Mailing Address - Country:US
Mailing Address - Phone:605-342-4333
Mailing Address - Fax:
Practice Address - Street 1:2720 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8128
Practice Address - Country:US
Practice Address - Phone:605-342-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1549111N00000X
SD1164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor