Provider Demographics
NPI:1326601337
Name:CHIROPRACTIC ESSENCE PLLC
Entity Type:Organization
Organization Name:CHIROPRACTIC ESSENCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ALGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-308-8161
Mailing Address - Street 1:3424 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-3211
Mailing Address - Country:US
Mailing Address - Phone:712-308-8161
Mailing Address - Fax:712-308-8161
Practice Address - Street 1:3424 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3211
Practice Address - Country:US
Practice Address - Phone:712-308-8161
Practice Address - Fax:712-308-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty