Provider Demographics
NPI:1639770282
Name:FOUNDATION CHIROPRACTIC & WELLNESS, PC
Entity Type:Organization
Organization Name:FOUNDATION CHIROPRACTIC & WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-320-2503
Mailing Address - Street 1:502 NE 9TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2201
Mailing Address - Country:US
Mailing Address - Phone:515-259-0501
Mailing Address - Fax:
Practice Address - Street 1:502 NE 9TH ST
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-2201
Practice Address - Country:US
Practice Address - Phone:515-259-0501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty