Provider Demographics
NPI:1750467296
Name:DIXON FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:DIXON FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:RJ
Authorized Official - Last Name:DROEGMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-336-1365
Mailing Address - Street 1:2704 ENTERPRISE AVE
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1073
Mailing Address - Country:US
Mailing Address - Phone:712-336-1365
Mailing Address - Fax:712-336-0924
Practice Address - Street 1:2704 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1073
Practice Address - Country:US
Practice Address - Phone:712-336-1365
Practice Address - Fax:712-336-0924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IADG3118OtherRR MEDICARE
IADG3118OtherRR MEDICARE