1245699966 NPI number — MEYER CHIROPRACTIC PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245699966 NPI number — MEYER CHIROPRACTIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEYER CHIROPRACTIC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245699966
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
612 NE 4TH ST
Provider Second Line Business Mailing Address:
APT 1
Provider Business Mailing Address City Name:
GRIMES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50111-2208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-521-8337
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1129 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEVADA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50201-1827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-382-2225
Provider Business Practice Location Address Fax Number:
515-382-5430
Provider Enumeration Date:
02/23/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MEYER
Authorized Official First Name:
JEREMY
Authorized Official Middle Name:
EUGENE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
641-521-8337

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  007406 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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