Provider Demographics
NPI:1982999025
Name:HANISCH FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HANISCH FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HANISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BS
Authorized Official - Phone:515-276-2263
Mailing Address - Street 1:4539 DOUGLAS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-2711
Mailing Address - Country:US
Mailing Address - Phone:515-276-2263
Mailing Address - Fax:515-251-2969
Practice Address - Street 1:4539 DOUGLAS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-2711
Practice Address - Country:US
Practice Address - Phone:515-276-2263
Practice Address - Fax:515-251-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center