Provider Demographics
NPI:1982932760
Name:ELKADER CLINIC LTD PC
Entity Type:Organization
Organization Name:ELKADER CLINIC LTD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-245-1151
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:ELKADER
Mailing Address - State:IA
Mailing Address - Zip Code:52043-0028
Mailing Address - Country:US
Mailing Address - Phone:563-245-1151
Mailing Address - Fax:563-245-1186
Practice Address - Street 1:690 EAST BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-0028
Practice Address - Country:US
Practice Address - Phone:563-245-1151
Practice Address - Fax:563-245-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty