1386817526 NPI number — RAHE CHIROPRACTIC LLC

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 1386817526 NPI number — RAHE CHIROPRACTIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAHE CHIROPRACTIC LLC
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:
BALANCE CHIROPRACTIC & WELLNESS
Provider Other Organization Name Type Code:
3
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:
1386817526
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6611 UNIVERSITY AVE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
WINDSOR HEIGHTS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50311-1655
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-255-5330
Provider Business Mailing Address Fax Number:
515-255-5256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 SE 30TH ST STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANKENY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50021-9324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-255-5330
Provider Business Practice Location Address Fax Number:
855-704-1568
Provider Enumeration Date:
04/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RAHE
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER/MANAGER/CHIROPRACTOR
Authorized Official Telephone Number:
515-255-5330

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  06753 , 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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