Provider Demographics
NPI:1861680126
Name:CHIROPRACTIC IN MOTION, INC.
Entity Type:Organization
Organization Name:CHIROPRACTIC IN MOTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:KRISTA
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-254-0481
Mailing Address - Street 1:4150 WESTOWN PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5901
Mailing Address - Country:US
Mailing Address - Phone:515-267-9956
Mailing Address - Fax:
Practice Address - Street 1:4150 WESTOWN PKWY STE 201
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5901
Practice Address - Country:US
Practice Address - Phone:515-267-9956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty