Provider Demographics
NPI:1275836827
Name:KAHLE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:KAHLE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:KAHLE
Authorized Official - Last Name:NETOLICKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-247-4782
Mailing Address - Street 1:3200 16TH AVE SW
Mailing Address - Street 2:SUITE I
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-1469
Mailing Address - Country:US
Mailing Address - Phone:319-247-4782
Mailing Address - Fax:319-247-4784
Practice Address - Street 1:3200 16TH AVE SW
Practice Address - Street 2:SUITE I
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-1469
Practice Address - Country:US
Practice Address - Phone:319-247-4782
Practice Address - Fax:319-247-4784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty