Provider Demographics
NPI:1073813226
Name:COX CHIROPRACTIC CLINIC PLC
Entity Type:Organization
Organization Name:COX CHIROPRACTIC CLINIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - DR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:JAME
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-385-1430
Mailing Address - Street 1:520 S. GRAND AVE.
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-1834
Mailing Address - Country:US
Mailing Address - Phone:319-385-1430
Mailing Address - Fax:319-385-1431
Practice Address - Street 1:520 S. GRAND AVE.
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-1834
Practice Address - Country:US
Practice Address - Phone:319-385-1430
Practice Address - Fax:319-385-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1972Medicare PIN
IA42464Medicare PIN