Provider Demographics
NPI:1386160349
Name:VIM CHIROPRACTIC AND WELLNESS PLC
Entity type:Organization
Organization Name:VIM CHIROPRACTIC AND WELLNESS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-294-4855
Mailing Address - Street 1:5300 EDGEWOOD RD NE STE 200
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-4706
Mailing Address - Country:US
Mailing Address - Phone:319-294-4855
Mailing Address - Fax:
Practice Address - Street 1:5300 EDGEWOOD RD NE STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52411-4706
Practice Address - Country:US
Practice Address - Phone:319-294-4855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty