Provider Demographics
NPI:1154674620
Name:NATURAL FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NATURAL FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLABAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-336-2626
Mailing Address - Street 1:909 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1429
Mailing Address - Country:US
Mailing Address - Phone:701-541-3652
Mailing Address - Fax:
Practice Address - Street 1:1306 18TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1163
Practice Address - Country:US
Practice Address - Phone:712-336-2626
Practice Address - Fax:712-336-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007515261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center