Provider Demographics
NPI:1285077552
Name:CAPITAL CHIROPRACTIC AND REHABILITATION CENTER, PLLC
Entity type:Organization
Organization Name:CAPITAL CHIROPRACTIC AND REHABILITATION CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LORANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-421-4018
Mailing Address - Street 1:601 E LOCUST ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1945
Mailing Address - Country:US
Mailing Address - Phone:515-421-4018
Mailing Address - Fax:515-421-4019
Practice Address - Street 1:601 E LOCUST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1945
Practice Address - Country:US
Practice Address - Phone:515-421-4018
Practice Address - Fax:515-421-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007618261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service