Provider Demographics
NPI:1508075524
Name:WALTER FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:WALTER FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CODY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-454-6455
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:52209-0267
Mailing Address - Country:US
Mailing Address - Phone:319-454-6455
Mailing Address - Fax:319-454-0091
Practice Address - Street 1:105 AND A HALF LOCUST ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLAIRSTOWN
Practice Address - State:IA
Practice Address - Zip Code:52209
Practice Address - Country:US
Practice Address - Phone:319-454-6455
Practice Address - Fax:319-454-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI22072Medicare PIN