Provider Demographics
NPI:1275800898
Name:HEALTHY LIVING CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:HEALTHY LIVING CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:SIEFKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-552-7236
Mailing Address - Street 1:8558 KAPP DR
Mailing Address - Street 2:P.O. BOX 183
Mailing Address - City:PEOSTA
Mailing Address - State:IA
Mailing Address - Zip Code:52068-9759
Mailing Address - Country:US
Mailing Address - Phone:563-552-7236
Mailing Address - Fax:
Practice Address - Street 1:8558 KAPP DR
Practice Address - Street 2:SUITE B
Practice Address - City:PEOSTA
Practice Address - State:IA
Practice Address - Zip Code:52068-9759
Practice Address - Country:US
Practice Address - Phone:563-552-7236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty