Provider Demographics
NPI:1659347292
Name:PULLEY CHIROPRACTIC INC
Entity type:Organization
Organization Name:PULLEY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAXTON
Authorized Official - Middle Name:N
Authorized Official - Last Name:PULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-288-8058
Mailing Address - Street 1:300 E LOCUST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309
Mailing Address - Country:US
Mailing Address - Phone:515-288-8058
Mailing Address - Fax:515-288-8793
Practice Address - Street 1:300 E LOCUST ST
Practice Address - Street 2:SUITE 140
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1863
Practice Address - Country:US
Practice Address - Phone:515-288-8058
Practice Address - Fax:515-288-8793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty