Provider Demographics
NPI:1326788175
Name:PEARL CITY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PEARL CITY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-263-3800
Mailing Address - Street 1:228 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-3738
Mailing Address - Country:US
Mailing Address - Phone:563-263-3800
Mailing Address - Fax:
Practice Address - Street 1:228 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-3738
Practice Address - Country:US
Practice Address - Phone:563-263-3800
Practice Address - Fax:563-263-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty