Provider Demographics
NPI:1922533215
Name:HIROTA CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HIROTA CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIROTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-512-5449
Mailing Address - Street 1:1315 6TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-4815
Mailing Address - Country:US
Mailing Address - Phone:641-424-5171
Mailing Address - Fax:641-423-1014
Practice Address - Street 1:1315 6TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-4815
Practice Address - Country:US
Practice Address - Phone:641-424-5171
Practice Address - Fax:641-423-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty