Healthcare Provider Details

I. General information

NPI: 1386917706
Provider Name (Legal Business Name): MARIAHS FAMILY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 AVENUE G
FORT MADISON IA
52627-4502
US

IV. Provider business mailing address

939 AVENUE G
FORT MADISON IA
52627-4502
US

V. Phone/Fax

Practice location:
  • Phone: 319-246-1759
  • Fax: 319-246-1760
Mailing address:
  • Phone: 319-246-1759
  • Fax: 319-246-1760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number007477
License Number StateIA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. MARIAH KAY RASHID
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 319-246-1759