Provider Demographics
NPI:1043343098
Name:EICKERT CHIROPRACTIC CLINIC PLLC
Entity Type:Organization
Organization Name:EICKERT CHIROPRACTIC CLINIC PLLC
Other - Org Name:WEST UNION CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:EICKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-422-3323
Mailing Address - Street 1:317 HIGHWAY 150 NORTH
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:IA
Mailing Address - Zip Code:52175
Mailing Address - Country:US
Mailing Address - Phone:563-422-3323
Mailing Address - Fax:
Practice Address - Street 1:317 HIGHWAY 150 NORTH
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:IA
Practice Address - Zip Code:52175-1450
Practice Address - Country:US
Practice Address - Phone:563-422-3323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty