Provider Demographics
NPI:1770795403
Name:GASKELL CHIROPRACTIC SERVICES PC
Entity type:Organization
Organization Name:GASKELL CHIROPRACTIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-255-7037
Mailing Address - Street 1:2609 GORDON DRIVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-5745
Mailing Address - Country:US
Mailing Address - Phone:712-255-7037
Mailing Address - Fax:712-255-1353
Practice Address - Street 1:2609 GORDON DRIVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-5745
Practice Address - Country:US
Practice Address - Phone:712-255-7037
Practice Address - Fax:712-255-1353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0289736Medicaid
IA0289736Medicaid