Provider Demographics
NPI:1407926298
Name:ALBLEVINS CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ALBLEVINS CHIROPRACTIC, INC.
Other - Org Name:BLEVINS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-344-8785
Mailing Address - Street 1:1530 STATE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4955
Mailing Address - Country:US
Mailing Address - Phone:563-344-8785
Mailing Address - Fax:563-344-8785
Practice Address - Street 1:1530 STATE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4955
Practice Address - Country:US
Practice Address - Phone:563-344-8785
Practice Address - Fax:563-344-8785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06561111N00000X
IN08002063A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI15185Medicare ID - Type UnspecifiedCORPORATION NUMBER