Provider Demographics
NPI:1215127121
Name:SIOUX CENTER CHIROPRACTIC WELLNESS AND CLINIC PC
Entity type:Organization
Organization Name:SIOUX CENTER CHIROPRACTIC WELLNESS AND CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-722-0788
Mailing Address - Street 1:81 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-1555
Mailing Address - Country:US
Mailing Address - Phone:712-722-0788
Mailing Address - Fax:712-722-0789
Practice Address - Street 1:81 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-1555
Practice Address - Country:US
Practice Address - Phone:712-722-0788
Practice Address - Fax:712-722-0789
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LARRY D ARMSTRONG DC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA21210Medicare PIN