Provider Demographics
NPI:1124691266
Name:IOWA CHIROPRACTIC OF GRIMES PC
Entity type:Organization
Organization Name:IOWA CHIROPRACTIC OF GRIMES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-964-3000
Mailing Address - Street 1:1451 SE 3RD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-4847
Mailing Address - Country:US
Mailing Address - Phone:515-452-0250
Mailing Address - Fax:
Practice Address - Street 1:1451 SE 3RD ST STE 100
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-4847
Practice Address - Country:US
Practice Address - Phone:515-452-0250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty