Healthcare Provider Details

I. General information

NPI: 1215328885
Provider Name (Legal Business Name): ACUTECHIRO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S 4TH ST
FOREST CITY IA
50436-1743
US

IV. Provider business mailing address

117 S 4TH ST
FOREST CITY IA
50436-1743
US

V. Phone/Fax

Practice location:
  • Phone: 641-582-2080
  • Fax: 641-582-2080
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number06906
License Number StateIA

VIII. Authorized Official

Name: DR. TJODE MICKELSON
Title or Position: OWNER
Credential: DC
Phone: 314-398-5800