Provider Demographics
NPI:1912041609
Name:CHIROPRACTIC REHAB CENTER, PC
Entity Type:Organization
Organization Name:CHIROPRACTIC REHAB CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SPURLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-582-4357
Mailing Address - Street 1:2255 JOHN F KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2846
Mailing Address - Country:US
Mailing Address - Phone:563-582-4357
Mailing Address - Fax:563-582-5718
Practice Address - Street 1:2255 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2846
Practice Address - Country:US
Practice Address - Phone:563-582-4357
Practice Address - Fax:563-582-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty