Provider Demographics
NPI:1386739274
Name:MOLSTRE INC.
Entity type:Organization
Organization Name:MOLSTRE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLSTRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-225-2266
Mailing Address - Street 1:14225 UNIVERSITY AVENUE
Mailing Address - Street 2:118
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263
Mailing Address - Country:US
Mailing Address - Phone:515-225-2266
Mailing Address - Fax:515-225-2296
Practice Address - Street 1:14225 UNIVERSITY AVENUE
Practice Address - Street 2:118
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263
Practice Address - Country:US
Practice Address - Phone:515-225-2266
Practice Address - Fax:515-225-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty