Healthcare Provider Details

I. General information

NPI: 1083729958
Provider Name (Legal Business Name): HEALING ARTS CENTER PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N CLARK ST
CARROLL IA
51401-2534
US

IV. Provider business mailing address

715 N CLARK ST
CARROLL IA
51401-2534
US

V. Phone/Fax

Practice location:
  • Phone: 712-792-4600
  • Fax:
Mailing address:
  • Phone: 712-792-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06649
License Number StateIA

VIII. Authorized Official

Name: ANGELA CROSS
Title or Position: OWNER
Credential: DC
Phone: 712-792-4600