MEDICARE: WASHINGTON CHIROPRACTIC, PC

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	06764	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38213	OTHER	IA	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558353284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON CHIROPRACTIC, PC

Provider Business Mailing Address
First Line	:	109 N MARION AVE
Second Line	:
City	:	WASHINGTON
State	:	IA
Zip	:	52353-1728
Country	:	US
Telephone Number	:	319-653-5381
Fax Number	:	319-653-6299

Provider Business Practice Location Address
First Line	:	109 N MARION AVE
Second Line	:
City	:	WASHINGTON
State	:	IA
Zip	:	52353-1728
Country	:	US
Telephone Number	:	319-653-5381
Fax Number	:	319-653-6299

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. TIMOTHY A WILBANKS
Credential	:	D.C.
Telephone Number	:	319-653-5381

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	10/04/2007

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Directions to “WASHINGTON CHIROPRACTIC, PC ” Practice Location

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