Healthcare Provider Details

I. General information

NPI: 1790950590
Provider Name (Legal Business Name): BALL CLINIC OF CHIROPRACTIC P.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 11/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 N LINN AVE
NEW HAMPTON IA
50659-1236
US

IV. Provider business mailing address

622 N LINN AVE
NEW HAMPTON IA
50659-1236
US

V. Phone/Fax

Practice location:
  • Phone: 641-394-3911
  • Fax:
Mailing address:
  • Phone: 641-394-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number007028
License Number StateIA

VIII. Authorized Official

Name: DR. KIMBERLY KAY BALL
Title or Position: OWNER
Credential: D.C.
Phone: 641-394-3911