Provider Demographics
NPI:1881828077
Name:HEALTHSOURCE OF ARMSTRONG, PC
Entity Type:Organization
Organization Name:HEALTHSOURCE OF ARMSTRONG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REZAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-868-4404
Mailing Address - Street 1:606 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ARMSTRONG
Mailing Address - State:IA
Mailing Address - Zip Code:50514-7420
Mailing Address - Country:US
Mailing Address - Phone:712-868-4404
Mailing Address - Fax:712-864-3646
Practice Address - Street 1:606 2ND AVE
Practice Address - Street 2:
Practice Address - City:ARMSTRONG
Practice Address - State:IA
Practice Address - Zip Code:50514-7420
Practice Address - Country:US
Practice Address - Phone:712-868-4404
Practice Address - Fax:712-864-3646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty