Provider Demographics
NPI:1427629278
Name:ROBERT CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:ROBERT CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-228-2810
Mailing Address - Street 1:705 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616-2125
Mailing Address - Country:US
Mailing Address - Phone:641-228-2810
Mailing Address - Fax:
Practice Address - Street 1:705 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-2125
Practice Address - Country:US
Practice Address - Phone:641-228-2810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty