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General NPI Number Information
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NPI Number | 1104993328
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Entity Type | Organization
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Legal Business Name | EMMETSBURG CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2301 MAIN ST
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City | EMMETSBURG
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State | IA
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Zip | 50536-1552
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Country | US
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Telephone | 712-852-3773
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Fax | 712-852-3773
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Provider Business Mailing Address
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Address Line | 2301 MAIN ST
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City | EMMETSBURG
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State | IA
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Zip | 50536-1552
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Country | US
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Telephone | 712-852-3773
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Fax | 712-852-3773
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JAMES BIRD
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Credential | D.C.
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Telephone | 712-852-3773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | A06016
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License Number State | IA
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