Healthcare Provider Details

I. General information

NPI: 1407829807
Provider Name (Legal Business Name): JOEL THOMAS REXROTH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 01/25/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 W MOUNT PLEASANT ST
WEST BURLINGTON IA
52655-9614
US

IV. Provider business mailing address

2411 W MOUNT PLEASANT ST
W BURLINGTON IA
52655-9614
US

V. Phone/Fax

Practice location:
  • Phone: 319-752-4544
  • Fax: 319-753-5879
Mailing address:
  • Phone: 319-752-4544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06469
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: