Provider Demographics
NPI:1972880698
Name:MITCHELLVILLE FAMILY CHIROPRACTIC P. C.
Entity Type:Organization
Organization Name:MITCHELLVILLE FAMILY CHIROPRACTIC P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-790-1094
Mailing Address - Street 1:301 CENTER AVE S
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50169-9751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 CENTER AVE S
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:IA
Practice Address - Zip Code:50169-9751
Practice Address - Country:US
Practice Address - Phone:712-790-1094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty