Provider Demographics
NPI:1043503493
Name:CAROLUS CHIROPRACTIC & WELLNESS CENTER
Entity Type:Organization
Organization Name:CAROLUS CHIROPRACTIC & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAROLUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-318-1246
Mailing Address - Street 1:5925 NW 54TH CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1421
Mailing Address - Country:US
Mailing Address - Phone:515-318-1246
Mailing Address - Fax:
Practice Address - Street 1:5765 MERLE HAY RD STE 10
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2810
Practice Address - Country:US
Practice Address - Phone:515-318-1246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty