Provider Demographics
NPI:1841301892
Name:EASTERN IOWA CHIROPRACTIC CENTRE, PC
Entity type:Organization
Organization Name:EASTERN IOWA CHIROPRACTIC CENTRE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SALOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-653-6000
Mailing Address - Street 1:112 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-2023
Mailing Address - Country:US
Mailing Address - Phone:319-653-6000
Mailing Address - Fax:319-653-6115
Practice Address - Street 1:112 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-2023
Practice Address - Country:US
Practice Address - Phone:319-653-6000
Practice Address - Fax:319-653-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA09744OtherWELLMARK FOR DR WEBER
IA10251OtherWELLMARK FOR DR SALOW
IA10251OtherWELLMARK FOR DR SALOW
IAI14942Medicare ID - Type UnspecifiedGROUP MEDICARE NO.
IA09744OtherWELLMARK FOR DR WEBER