Provider Demographics
NPI:1790173268
Name:URBANDALE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:URBANDALE CHIROPRACTIC PC
Other - Org Name:URBANDALE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ENGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:515-278-4594
Mailing Address - Street 1:10437 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3727
Mailing Address - Country:US
Mailing Address - Phone:515-278-4594
Mailing Address - Fax:515-278-4608
Practice Address - Street 1:10437 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3727
Practice Address - Country:US
Practice Address - Phone:515-278-4594
Practice Address - Fax:515-278-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty