Healthcare Provider Details

I. General information

NPI: 1184896086
Provider Name (Legal Business Name): ADOLPHSON CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3043 CENTER POINT RD NE
CEDAR RAPIDS IA
52402-4037
US

IV. Provider business mailing address

3043 CENTER POINT RD NE
CEDAR RAPIDS IA
52402-4037
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-5000
  • Fax: 319-364-0690
Mailing address:
  • Phone: 319-364-5000
  • Fax: 319-364-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberIA5033
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0223933
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: DR. BARTH ADOLPHSON
Title or Position: PRESIDENT
Credential: D.C.
Phone: 319-364-5000