Provider Demographics
NPI:1619737749
Name:CONNECT CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CONNECT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-509-7394
Mailing Address - Street 1:1210 6TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-1548
Mailing Address - Country:US
Mailing Address - Phone:515-934-8267
Mailing Address - Fax:515-934-8269
Practice Address - Street 1:1210 6TH ST STE 103
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-1548
Practice Address - Country:US
Practice Address - Phone:515-934-8267
Practice Address - Fax:515-934-8269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty