Provider Demographics
NPI:1982637641
Name:UTECH CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:UTECH CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:UTECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-236-8988
Mailing Address - Street 1:603 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1942
Mailing Address - Country:US
Mailing Address - Phone:641-236-8988
Mailing Address - Fax:641-236-8172
Practice Address - Street 1:603 6TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1942
Practice Address - Country:US
Practice Address - Phone:641-236-8988
Practice Address - Fax:641-236-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA39027OtherBCBS OF IOWA GROUP NUMBER
IA39027OtherBCBS OF IOWA GROUP NUMBER