Healthcare Provider Details

I. General information

NPI: 1073770574
Provider Name (Legal Business Name): CHIROPRACTIC CONNECTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 MAIN ST
NASHUA IA
50658-9482
US

IV. Provider business mailing address

322 MAIN ST
NASHUA IA
50658-9482
US

V. Phone/Fax

Practice location:
  • Phone: 641-435-2102
  • Fax:
Mailing address:
  • Phone: 641-435-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number007012
License Number StateIA

VIII. Authorized Official

Name: DR. MORGAN RAE POMMREHN-JASS
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 641-435-2102