Provider Demographics
NPI:1821278631
Name:HINDERMAN CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:HINDERMAN CHIROPRACTIC INC.
Other - Org Name:FAMILY FIRST CHIROPRACTIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HINDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-556-6921
Mailing Address - Street 1:998 FREMONT AVE
Mailing Address - Street 2:STE. L1
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-0300
Mailing Address - Country:US
Mailing Address - Phone:563-556-6921
Mailing Address - Fax:563-556-6923
Practice Address - Street 1:998 FREMONT AVE
Practice Address - Street 2:STE. L1
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-0300
Practice Address - Country:US
Practice Address - Phone:563-556-6921
Practice Address - Fax:563-556-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06886261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center