Healthcare Provider Details
I. General information
NPI: 1396987269
Provider Name (Legal Business Name): PRAHL HEALTH&HEALING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/24/2009
Last Update Date: 03/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
226 BRANDILYNN BLVD SUITE D
CEDAR FALLS IA
50613-7410
US
IV. Provider business mailing address
1031 BLACKHAWK ST
REINBECK IA
50669-1409
US
V. Phone/Fax
- Phone: 319-266-7788
- Fax: 319-266-8088
- Phone: 319-558-6023
- Fax: 319-266-7788
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 05094 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 05094 |
| License Number State | IA |
VIII. Authorized Official
Name:
VALORIE
J.
PRAHL
Title or Position: CEO, REGISTERED AGENT
Credential: D.C.,C.C.N.,D.A.C.B.
Phone: 319-558-6023