Provider Demographics
NPI:1235754946
Name:STRUCK CHIROPRACTIC
Entity Type:Organization
Organization Name:STRUCK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STRUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-210-6473
Mailing Address - Street 1:107 8TH ST N
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:50459-1332
Mailing Address - Country:US
Mailing Address - Phone:712-210-6473
Mailing Address - Fax:
Practice Address - Street 1:308 4TH AVE NW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-3140
Practice Address - Country:US
Practice Address - Phone:507-437-3655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty