Provider Demographics
NPI:1821450628
Name:TIFFIN CHIROPRACTIC CENTER P.L.C.
Entity Type:Organization
Organization Name:TIFFIN CHIROPRACTIC CENTER P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KEINROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-545-1000
Mailing Address - Street 1:211 WEST MARENGO RD. SUITE 2
Mailing Address - Street 2:P.O. BOX 528
Mailing Address - City:TIFFIN
Mailing Address - State:IA
Mailing Address - Zip Code:52340-0528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:319-538-0319
Practice Address - Street 1:211 WEST MARENGO RD
Practice Address - Street 2:SUITE 2
Practice Address - City:TIFFIN
Practice Address - State:IA
Practice Address - Zip Code:52340-0528
Practice Address - Country:US
Practice Address - Phone:563-920-7975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078969305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service