Provider Demographics
NPI:1437380466
Name:HEARTLAND CHIROPRACTIC AND WELLNESS CENTER, PLC
Entity Type:Organization
Organization Name:HEARTLAND CHIROPRACTIC AND WELLNESS CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:SKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-252-8668
Mailing Address - Street 1:5521 NW 86TH ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1730
Mailing Address - Country:US
Mailing Address - Phone:515-252-8668
Mailing Address - Fax:515-270-2457
Practice Address - Street 1:5521 NW 86TH ST
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1730
Practice Address - Country:US
Practice Address - Phone:515-252-8668
Practice Address - Fax:515-270-2457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty