Provider Demographics
NPI:1508058223
Name:NEVADA FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:NEVADA FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:GRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-382-3255
Mailing Address - Street 1:805 LINCOLN HWY STE A
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-1719
Mailing Address - Country:US
Mailing Address - Phone:515-382-3255
Mailing Address - Fax:515-382-3256
Practice Address - Street 1:805 LINCOLN HWY STE A
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-1719
Practice Address - Country:US
Practice Address - Phone:515-382-3255
Practice Address - Fax:515-382-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty