Provider Demographics
NPI:1023112026
Name:COMPLETE CHIROPRACTIC HEALTH & WELLNESS
Entity type:Organization
Organization Name:COMPLETE CHIROPRACTIC HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:W
Authorized Official - Last Name:DEJAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-752-1107
Mailing Address - Street 1:2415 MT PLEASANT ST
Mailing Address - Street 2:STE A
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-2751
Mailing Address - Country:US
Mailing Address - Phone:319-752-1107
Mailing Address - Fax:319-752-1108
Practice Address - Street 1:2415 MT PLEASANT ST
Practice Address - Street 2:STE A
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-2751
Practice Address - Country:US
Practice Address - Phone:319-752-1107
Practice Address - Fax:319-752-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U97124Medicare UPIN
IA1I6031Medicare ID - Type Unspecified