Provider Demographics
NPI:1912340399
Name:IOWA CITY CHIROPRACTIC
Entity type:Organization
Organization Name:IOWA CITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:YOUNTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-338-5665
Mailing Address - Street 1:302 SCOTT CT
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-3951
Mailing Address - Country:US
Mailing Address - Phone:319-338-5665
Mailing Address - Fax:
Practice Address - Street 1:302 SCOTT CT
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3951
Practice Address - Country:US
Practice Address - Phone:319-338-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty