Provider Demographics
NPI:1063709467
Name:NEAL CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:NEAL CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-324-6325
Mailing Address - Street 1:506 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-4331
Mailing Address - Country:US
Mailing Address - Phone:563-940-7176
Mailing Address - Fax:563-323-5180
Practice Address - Street 1:506 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-4331
Practice Address - Country:US
Practice Address - Phone:563-940-7176
Practice Address - Fax:563-323-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty