Healthcare Provider Details
I. General information
NPI: 1740465418
Provider Name (Legal Business Name): SAYLORVILLE CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/31/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6633 NW 6TH DR STE 3
DES MOINES IA
50313-1008
US
IV. Provider business mailing address
6633 NW 6TH DR APT 3
DES MOINES IA
50313-1008
US
V. Phone/Fax
- Phone: 515-289-0400
- Fax: 515-289-0424
- Phone: 515-289-0400
- Fax: 515-289-0424
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | |
| License Number State | IA |
VIII. Authorized Official
Name: DR.
JASON
M
SCHLICHTE
Title or Position: PRESIDENT
Credential: DC
Phone: 515-289-0400