Provider Demographics
NPI:1477189538
Name:ACME CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ACME CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-341-0120
Mailing Address - Street 1:701 NW SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1735
Mailing Address - Country:US
Mailing Address - Phone:515-341-0120
Mailing Address - Fax:
Practice Address - Street 1:701 NW SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1735
Practice Address - Country:US
Practice Address - Phone:515-341-0120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty