Provider Demographics
NPI:1770834202
Name:CHIROPRACTIC HEALTH CARE PC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-943-1550
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:401 1/2 E STREET
Mailing Address - City:SERGEANT BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:51054-0908
Mailing Address - Country:US
Mailing Address - Phone:712-943-1550
Mailing Address - Fax:
Practice Address - Street 1:401 1/2 E STREET
Practice Address - Street 2:
Practice Address - City:SERGEANT BLUFF
Practice Address - State:IA
Practice Address - Zip Code:51054-0908
Practice Address - Country:US
Practice Address - Phone:712-943-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA350049464OtherRAILROAD MEDICARE
IA24231OtherBLUE CROSS BLUE SHIELD
IA24231OtherBLUE CROSS BLUE SHIELD
IAT01375Medicare UPIN