Provider Demographics
NPI:1841563392
Name:CAMPBELL CHIROPRACTIC, PC
Entity type:Organization
Organization Name:CAMPBELL CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-732-2192
Mailing Address - Street 1:2795 120TH ST
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:IA
Mailing Address - Zip Code:52778-9335
Mailing Address - Country:US
Mailing Address - Phone:562-732-2192
Mailing Address - Fax:563-732-2192
Practice Address - Street 1:2795 120TH ST
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:IA
Practice Address - Zip Code:52778-9335
Practice Address - Country:US
Practice Address - Phone:562-732-2192
Practice Address - Fax:563-732-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty