Provider Demographics
NPI:1316093867
Name:MEADOR CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:MEADOR CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:PAT
Authorized Official - Last Name:MEADOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-209-1990
Mailing Address - Street 1:1100 W BURLINGTON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-2858
Mailing Address - Country:US
Mailing Address - Phone:641-209-1990
Mailing Address - Fax:319-293-3406
Practice Address - Street 1:1100 W BURLINGTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-2858
Practice Address - Country:US
Practice Address - Phone:641-209-1990
Practice Address - Fax:641-209-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty