Healthcare Provider Details

I. General information

NPI: 1669603254
Provider Name (Legal Business Name): BACK IN LINE FAMILY CHIROPRACTIC AND WELLNESS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 DINA CT
HIAWATHA IA
52233-4706
US

IV. Provider business mailing address

102 A AVE
HIAWATHA IA
52233-1504
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 TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CALLA JAYNE H KLEENE
Title or Position: OWNER
Credential: D.C.
Phone: 319-892-3034