Provider Demographics
NPI:1306227350
Name:TWEETON CHIROPRACTIC, PLC
Entity Type:Organization
Organization Name:TWEETON CHIROPRACTIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:TWEETON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-653-2351
Mailing Address - Street 1:214 S IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1753
Mailing Address - Country:US
Mailing Address - Phone:319-653-2351
Mailing Address - Fax:
Practice Address - Street 1:214 S IOWA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1753
Practice Address - Country:US
Practice Address - Phone:319-653-2351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1189837Medicaid
IAT01096Medicare UPIN
IA1189837Medicaid