Healthcare Provider Details

I. General information

NPI: 1982968152
Provider Name (Legal Business Name): SUMMIT CHIROPRACTIC CENTERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BROOKERIDGE DR
WATERLOO IA
50701-5214
US

IV. Provider business mailing address

40 BROOKERIDGE DR
WATERLOO IA
50701-5214
US

V. Phone/Fax

Practice location:
  • Phone: 319-232-2100
  • Fax: 319-232-6389
Mailing address:
  • Phone: 319-232-2100
  • Fax: 319-232-6389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SUZY DUWE
Title or Position: OFFICE MANAGER
Credential:
Phone: 319-827-2223