Provider Demographics
NPI:1669629879
Name:BOHNENKAMP CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:BOHNENKAMP CHIROPRACTIC P.C.
Other - Org Name:SUMMIT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHNENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-460-3160
Mailing Address - Street 1:4217 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-3421
Mailing Address - Country:US
Mailing Address - Phone:515-460-3160
Mailing Address - Fax:515-277-0377
Practice Address - Street 1:4217 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3421
Practice Address - Country:US
Practice Address - Phone:515-460-3160
Practice Address - Fax:515-277-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty