Provider Demographics
NPI:1184870792
Name:IOWA SCOLIOSIS CLINIC INC.
Entity type:Organization
Organization Name:IOWA SCOLIOSIS CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-423-0257
Mailing Address - Street 1:423 4TH ST SW STE A
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-3811
Mailing Address - Country:US
Mailing Address - Phone:641-423-0257
Mailing Address - Fax:641-424-0200
Practice Address - Street 1:423 4TH ST SW STE A
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-3811
Practice Address - Country:US
Practice Address - Phone:641-423-0257
Practice Address - Fax:641-424-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06519261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center