Provider Demographics
NPI:1689455974
Name:RIVER VALLEY FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:RIVER VALLEY FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYNEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-210-6538
Mailing Address - Street 1:304 6TH ST E
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:IA
Mailing Address - Zip Code:52315-9702
Mailing Address - Country:US
Mailing Address - Phone:319-654-4861
Mailing Address - Fax:
Practice Address - Street 1:116 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IA
Practice Address - Zip Code:52301-1545
Practice Address - Country:US
Practice Address - Phone:319-654-4861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care