Provider Demographics
NPI:1295057263
Name:AMES CHIROPRACTIC CENTER P.C
Entity type:Organization
Organization Name:AMES CHIROPRACTIC CENTER P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-232-3374
Mailing Address - Street 1:819 W LINCOLN WAY
Mailing Address - Street 2:STE B
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6947
Mailing Address - Country:US
Mailing Address - Phone:515-232-3374
Mailing Address - Fax:515-232-0121
Practice Address - Street 1:819 W LINCOLN WAY
Practice Address - Street 2:STE B
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6947
Practice Address - Country:US
Practice Address - Phone:515-232-3374
Practice Address - Fax:515-232-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA03194Medicare UPIN