Healthcare Provider Details

I. General information

NPI: 1629208467
Provider Name (Legal Business Name): CALLA JAYNE HENNING KLEENE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 05/11/2024
Certification Date: 05/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 DINA CT
HIAWATHA IA
52233-4706
US

IV. Provider business mailing address

99 NORTH CENTER POINT ROAD
HIAWATHA IA
52233-1401
US

V. Phone/Fax

Practice location:
  • Phone: 319-892-3363
  • Fax: 319-892-3034
Mailing address:
  • Phone: 319-892-3363
  • Fax: 319-892-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007222
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: