Provider Demographics
NPI:1083991954
Name:TCB CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:TCB CHIROPRACTIC, LLC
Other - Org Name:TCB CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:WHEAT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-233-5910
Mailing Address - Street 1:1606 GOLDEN ASPEN DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8011
Mailing Address - Country:US
Mailing Address - Phone:515-233-5910
Mailing Address - Fax:515-233-8882
Practice Address - Street 1:1606 GOLDEN ASPEN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8011
Practice Address - Country:US
Practice Address - Phone:515-233-5910
Practice Address - Fax:515-233-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty