Provider Demographics
NPI:1184896086
Name:ADOLPHSON CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:ADOLPHSON CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:ADOLPHSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-364-5000
Mailing Address - Street 1:3043 CENTER POINT RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-4037
Mailing Address - Country:US
Mailing Address - Phone:319-364-5000
Mailing Address - Fax:319-364-0690
Practice Address - Street 1:3043 CENTER POINT RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4037
Practice Address - Country:US
Practice Address - Phone:319-364-5000
Practice Address - Fax:319-364-0690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA5033261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0223933Medicaid
IA22393Medicare PIN