Healthcare Provider Details

I. General information

NPI: 1942274238
Provider Name (Legal Business Name): WARREN COUNTY CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W 2ND AVE
INDIANOLA IA
50125-2522
US

IV. Provider business mailing address

102 W 2ND AVE
INDIANOLA IA
50125-2522
US

V. Phone/Fax

Practice location:
  • Phone: 515-962-2166
  • Fax: 515-962-2177
Mailing address:
  • Phone: 515-962-2166
  • Fax: 515-962-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON J VILLALOBOS
Title or Position: OWNER
Credential: DC
Phone: 515-962-2166