Provider Demographics
NPI:1346383619
Name:CYCLONE HEALTHCARE INC.
Entity Type:Organization
Organization Name:CYCLONE HEALTHCARE INC.
Other - Org Name:AMES BACK & NECK CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-233-1709
Mailing Address - Street 1:809 WHEELER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4367
Mailing Address - Country:US
Mailing Address - Phone:515-233-1709
Mailing Address - Fax:515-232-1917
Practice Address - Street 1:809 WHEELER ST STE 2
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4367
Practice Address - Country:US
Practice Address - Phone:515-233-1709
Practice Address - Fax:515-232-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0087973Medicaid
IA42678OtherBLUE CROSS PROVIDER #
IA42678OtherBLUE CROSS PROVIDER #
IAT01466Medicare UPIN