Provider Demographics
NPI:1831373935
Name:GENGLER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:GENGLER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:GENGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-226-8495
Mailing Address - Street 1:12871 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8255
Mailing Address - Country:US
Mailing Address - Phone:515-226-8495
Mailing Address - Fax:515-226-8497
Practice Address - Street 1:12871 UNIVERSITY AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8255
Practice Address - Country:US
Practice Address - Phone:515-226-8495
Practice Address - Fax:515-226-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty