Healthcare Provider Details

I. General information

NPI: 1790173268
Provider Name (Legal Business Name): URBANDALE CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2015
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10437 HICKMAN RD
URBANDALE IA
50322-3727
US

IV. Provider business mailing address

10437 HICKMAN RD
URBANDALE IA
50322-3727
US

V. Phone/Fax

Practice location:
  • Phone: 515-278-4594
  • Fax: 515-278-4608
Mailing address:
  • Phone: 515-278-4594
  • Fax: 515-278-4608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JODY LYNN ENGLAND
Title or Position: OWNER/CHIROPRACTOR
Credential: D,C,
Phone: 515-278-4594