Provider Demographics
NPI:1396072484
Name:BOYSON CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:BOYSON CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMELROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-378-0562
Mailing Address - Street 1:1450 BOYSON RD
Mailing Address - Street 2:STE B4
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-2340
Mailing Address - Country:US
Mailing Address - Phone:319-378-0562
Mailing Address - Fax:319-378-3904
Practice Address - Street 1:1450 BOYSON RD
Practice Address - Street 2:STE B4
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-2340
Practice Address - Country:US
Practice Address - Phone:319-378-0562
Practice Address - Fax:319-378-3904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007252111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty