Provider Demographics
NPI:1356586606
Name:WEMARK CHIROPRACTIC LLC
Entity type:Organization
Organization Name:WEMARK CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEMARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-566-2686
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:105 W. MAIN ST.
Mailing Address - City:LIME SPRINGS
Mailing Address - State:IA
Mailing Address - Zip Code:52155-0062
Mailing Address - Country:US
Mailing Address - Phone:563-566-2686
Mailing Address - Fax:563-566-2686
Practice Address - Street 1:105 W MAIN ST.
Practice Address - Street 2:
Practice Address - City:LIME SPRINGS
Practice Address - State:IA
Practice Address - Zip Code:52155-0062
Practice Address - Country:US
Practice Address - Phone:563-566-2686
Practice Address - Fax:563-566-2686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0272369Medicaid
IAI7198Medicare UPIN