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General NPI Number Information
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NPI Number | 1114153053
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Entity Type | Organization
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Legal Business Name | EBERLINE FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 412 G AVE
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City | GRUNDY CENTER
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State | IA
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Zip | 50638-1747
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Country | US
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Telephone | 319-824-3650
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Fax | 319-824-6780
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Provider Business Mailing Address
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Address Line | PO BOX 52
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City | GRUNDY CENTER
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State | IA
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Zip | 50638-0052
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Country | US
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Telephone | 319-824-3650
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Fax | 319-824-6780
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL D. EBERLINE
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Credential | DCABN
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Telephone | 319-824-3650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 06488
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License Number State | IA
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