Provider Demographics
NPI:1194758896
Name:CHIROPRACTIC CONCEPTS
Entity type:Organization
Organization Name:CHIROPRACTIC CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:VELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC,CCSP
Authorized Official - Phone:712-336-1330
Mailing Address - Street 1:2007 18TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1061
Mailing Address - Country:US
Mailing Address - Phone:712-336-1330
Mailing Address - Fax:712-336-4240
Practice Address - Street 1:2007 18TH ST STE 1
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1061
Practice Address - Country:US
Practice Address - Phone:712-336-1330
Practice Address - Fax:712-336-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA5663111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1090308Medicaid
IAI12945Medicare ID - Type UnspecifiedPROVIDER NUMBER