Provider Demographics
NPI:1114099256
Name:ENGEL CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:ENGEL CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-622-3322
Mailing Address - Street 1:606 39TH AVE
Mailing Address - Street 2:PO BOX 302
Mailing Address - City:AMANA
Mailing Address - State:IA
Mailing Address - Zip Code:52203-8016
Mailing Address - Country:US
Mailing Address - Phone:319-622-3322
Mailing Address - Fax:319-622-3323
Practice Address - Street 1:606 39TH AVE
Practice Address - Street 2:
Practice Address - City:AMANA
Practice Address - State:IA
Practice Address - Zip Code:52203-8016
Practice Address - Country:US
Practice Address - Phone:319-622-3322
Practice Address - Fax:319-622-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1077115Medicaid
IAI4715Medicare ID - Type Unspecified
IAU21231Medicare UPIN