Provider Demographics
NPI:1225168818
Name:PRECISION CHIROPRACTIC WEST, PLC
Entity Type:Organization
Organization Name:PRECISION CHIROPRACTIC WEST, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-978-7331
Mailing Address - Street 1:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-0235
Mailing Address - Country:US
Mailing Address - Phone:515-978-7331
Mailing Address - Fax:515-978-7332
Practice Address - Street 1:470 W HICKMAN RD
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-5008
Practice Address - Country:US
Practice Address - Phone:515-978-7331
Practice Address - Fax:515-978-7332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty