Provider Demographics
NPI:1366717894
Name:MY CHIRO, L.L.C.
Entity type:Organization
Organization Name:MY CHIRO, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:WEISBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-396-2300
Mailing Address - Street 1:3221 16TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-1434
Mailing Address - Country:US
Mailing Address - Phone:319-721-8728
Mailing Address - Fax:
Practice Address - Street 1:3221 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-1434
Practice Address - Country:US
Practice Address - Phone:319-721-8728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty