Provider Demographics
NPI:1386783298
Name:RECKERS FAMILY CHIROPRACTIC SERVICES INC
Entity type:Organization
Organization Name:RECKERS FAMILY CHIROPRACTIC SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:P
Authorized Official - Last Name:RECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-465-2060
Mailing Address - Street 1:216 NORTH MAIN STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1748
Mailing Address - Country:US
Mailing Address - Phone:319-465-2060
Mailing Address - Fax:319-465-7022
Practice Address - Street 1:216 NORTH MAIN STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1748
Practice Address - Country:US
Practice Address - Phone:319-465-2060
Practice Address - Fax:319-465-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0246835Medicaid
IA240394OtherMIDLANDS CHOICE
IA42905OtherBLUE CROSS BLUE SHIELD
IA2192489OtherFIRST HEALTH
IAU86977Medicare UPIN
IAI15956Medicare PIN