Provider Demographics
NPI:1780012005
Name:VOSBERG CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:VOSBERG CHIROPRACTIC LLC
Other - Org Name:TEAM CHIROPRACTIC AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:VOSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-276-8326
Mailing Address - Street 1:8191 BIRCHWOOD CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2931
Mailing Address - Country:US
Mailing Address - Phone:515-276-8326
Mailing Address - Fax:515-276-5405
Practice Address - Street 1:8191 BIRCHWOOD CT
Practice Address - Street 2:SUITE C
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2931
Practice Address - Country:US
Practice Address - Phone:515-276-8326
Practice Address - Fax:515-276-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007704261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center