Provider Demographics
NPI:1346645546
Name:RARDIN CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:RARDIN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:AMYAS
Authorized Official - Last Name:RARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-990-9530
Mailing Address - Street 1:112 NE HAYES ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:50849-1048
Mailing Address - Country:US
Mailing Address - Phone:641-743-5756
Mailing Address - Fax:
Practice Address - Street 1:112 NE HAYES ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IA
Practice Address - Zip Code:50849-1048
Practice Address - Country:US
Practice Address - Phone:641-743-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06965111N00000X
IA06922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty