Provider Demographics
NPI:1427087683
Name:NURTURE CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:NURTURE CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOOKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-556-4240
Mailing Address - Street 1:989 LANGWORTHY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7368
Mailing Address - Country:US
Mailing Address - Phone:563-556-4240
Mailing Address - Fax:563-556-1673
Practice Address - Street 1:989 LANGWORTHY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7368
Practice Address - Country:US
Practice Address - Phone:563-556-4240
Practice Address - Fax:563-556-1673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06885111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty