Provider Demographics
NPI:1083850283
Name:DONNELLSON CHIROPRACTIC CLINIC, PC
Entity Type:Organization
Organization Name:DONNELLSON CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MAASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-835-9011
Mailing Address - Street 1:616 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:DONNELLSON
Mailing Address - State:IA
Mailing Address - Zip Code:52625-9453
Mailing Address - Country:US
Mailing Address - Phone:319-835-9011
Mailing Address - Fax:319-835-9012
Practice Address - Street 1:616 MADISON AVE
Practice Address - Street 2:
Practice Address - City:DONNELLSON
Practice Address - State:IA
Practice Address - Zip Code:52625-9453
Practice Address - Country:US
Practice Address - Phone:319-835-9011
Practice Address - Fax:319-835-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06716261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1427004365OtherNPPES
IAIB1321001OtherCMS
IAP00687137OtherPALMETTO GBA UTAN
IAIB1321OtherCMS
IAIB1321001OtherCMS