Healthcare Provider Details
I. General information
NPI: 1104750025
Provider Name (Legal Business Name): FOUNDATIONAL CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
146 N CLARK ST
FOREST CITY IA
50436-1643
US
IV. Provider business mailing address
146 N CLARK ST
FOREST CITY IA
50436-1643
US
V. Phone/Fax
- Phone: 641-585-4325
- Fax:
- Phone: 641-585-4325
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOELI
EMMA
KOENIG
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 515-351-8651