Provider Demographics
NPI:1699288241
Name:BURLINGTON FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:BURLINGTON FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTICIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:BROCK
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-208-9456
Mailing Address - Street 1:145 W BURLINGTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-1914
Mailing Address - Country:US
Mailing Address - Phone:319-289-9456
Mailing Address - Fax:319-208-9456
Practice Address - Street 1:145 W BURLINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-1914
Practice Address - Country:US
Practice Address - Phone:319-208-9456
Practice Address - Fax:319-208-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty