Provider Demographics
NPI:1215595988
Name:THE ROCK HEALTHCARE
Entity Type:Organization
Organization Name:THE ROCK HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-359-8813
Mailing Address - Street 1:2407 18TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3279
Mailing Address - Country:US
Mailing Address - Phone:563-359-8813
Mailing Address - Fax:563-355-8912
Practice Address - Street 1:2407 18TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3279
Practice Address - Country:US
Practice Address - Phone:563-359-8813
Practice Address - Fax:563-355-8912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2137976Medicaid