Provider Demographics
NPI:1811361074
Name:ANKENY CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:ANKENY CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:TANKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-777-1104
Mailing Address - Street 1:1605 SE DELAWARE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4594
Mailing Address - Country:US
Mailing Address - Phone:515-777-1104
Mailing Address - Fax:
Practice Address - Street 1:1605 SE DELAWARE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-4594
Practice Address - Country:US
Practice Address - Phone:515-777-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077636261QH0100X, 261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation