Provider Demographics
NPI:1124454806
Name:HANDELAND CHIROPRACTIC 2 LLC
Entity type:Organization
Organization Name:HANDELAND CHIROPRACTIC 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HANDELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-852-2266
Mailing Address - Street 1:P. O. BOX 91
Mailing Address - Street 2:
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536
Mailing Address - Country:US
Mailing Address - Phone:712-852-2266
Mailing Address - Fax:712-852-3728
Practice Address - Street 1:3687 450TH AVE
Practice Address - Street 2:
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536
Practice Address - Country:US
Practice Address - Phone:712-852-2266
Practice Address - Fax:712-852-3728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty