MEDICARE: REXROTH CHIROPRACTIC CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	06469	IA
2	111N00000X	Chiropractor	04045	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174853915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REXROTH CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	2411 W MOUNT PLEASANT ST
Second Line	:
City	:	WEST BURLINGTON
State	:	IA
Zip	:	52655-9614
Country	:	US
Telephone Number	:	319-752-4544
Fax Number	:	319-753-5879

Provider Business Practice Location Address
First Line	:	2411 W MOUNT PLEASANT ST
Second Line	:
City	:	WEST BURLINGTON
State	:	IA
Zip	:	52655-9614
Country	:	US
Telephone Number	:	319-752-4544
Fax Number	:	319-753-5879

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JENA MARIE WRIGHT
Credential	:
Telephone Number	:	319-752-4544

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	12/29/2009

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Directions to “REXROTH CHIROPRACTIC CENTER ” Practice Location

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