Provider Demographics
NPI:1558999516
Name:SUSIE CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:SUSIE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SUSIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-503-4255
Mailing Address - Street 1:3008 LINCOLN WAY STE B
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7240
Mailing Address - Country:US
Mailing Address - Phone:563-503-4255
Mailing Address - Fax:
Practice Address - Street 1:3008 LINCOLN WAY STE B
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7240
Practice Address - Country:US
Practice Address - Phone:563-503-4255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center