Provider Demographics
NPI:1649784547
Name:HEARTLAND FAMILY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:HEARTLAND FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-733-2050
Mailing Address - Street 1:628 BROAD ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:STORY CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50248
Mailing Address - Country:US
Mailing Address - Phone:515-733-2050
Mailing Address - Fax:
Practice Address - Street 1:628 BROAD ST
Practice Address - Street 2:SUITE 3
Practice Address - City:STORY CITY
Practice Address - State:IA
Practice Address - Zip Code:50248
Practice Address - Country:US
Practice Address - Phone:515-733-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA081092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty