Provider Demographics
NPI:1023223427
Name:ANN R. BORSETH, P.C.
Entity Type:Organization
Organization Name:ANN R. BORSETH, P.C.
Other - Org Name:NEW VIRGINIA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:BORSETH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-449-1108
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:NEW VIRGINIA
Mailing Address - State:IA
Mailing Address - Zip Code:50210-0454
Mailing Address - Country:US
Mailing Address - Phone:641-449-1108
Mailing Address - Fax:
Practice Address - Street 1:402 DAVIDSON ST
Practice Address - Street 2:
Practice Address - City:NEW VIRGINIA
Practice Address - State:IA
Practice Address - Zip Code:50210-9606
Practice Address - Country:US
Practice Address - Phone:641-449-1108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0203927Medicaid