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General NPI Number Information
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NPI Number | 1124454806
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Entity Type | Organization
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Legal Business Name | HANDELAND CHIROPRACTIC 2 LLC
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 3687 450TH AVE
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City | EMMETSBURG
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State | IA
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Zip | 50536
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Country | US
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Telephone | 712-852-2266
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Fax | 712-852-3728
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Provider Business Mailing Address
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Address Line | P. O. BOX 91
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City | EMMETSBURG
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State | IA
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Zip | 50536
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Country | US
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Telephone | 712-852-2266
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Fax | 712-852-3728
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. SHAWN MICHAEL HANDELAND
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Credential | D.C.
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Telephone | 712-852-2266
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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 | 007592
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License Number State | IA
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