Provider Demographics
NPI:1912225301
Name:CALMAR FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:CALMAR FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KOOZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-562-3362
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:CALMAR
Mailing Address - State:IA
Mailing Address - Zip Code:52132-0647
Mailing Address - Country:US
Mailing Address - Phone:563-562-3362
Mailing Address - Fax:563-562-3362
Practice Address - Street 1:114 N MARYVILLE ST
Practice Address - Street 2:
Practice Address - City:CALMAR
Practice Address - State:IA
Practice Address - Zip Code:52132-8520
Practice Address - Country:US
Practice Address - Phone:563-562-3362
Practice Address - Fax:563-562-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty