Provider Demographics
NPI:1205178472
Name:WILTON CHIROPRACTIC CLINIC, PLLC
Entity Type:Organization
Organization Name:WILTON CHIROPRACTIC CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOHE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-732-3100
Mailing Address - Street 1:127 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:IA
Mailing Address - Zip Code:52778-7746
Mailing Address - Country:US
Mailing Address - Phone:563-732-3100
Mailing Address - Fax:563-732-3100
Practice Address - Street 1:127 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:IA
Practice Address - Zip Code:52778-7746
Practice Address - Country:US
Practice Address - Phone:563-732-3100
Practice Address - Fax:563-732-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06647261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center