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General NPI Number Information
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NPI Number | 1154325124
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Entity Type | Organization
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Legal Business Name | BCC INC
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 2411 CORAL COURT SUITE 3
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City | CORALVILLE
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State | IA
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Zip | 52241
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Country | US
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Telephone | 319-545-4444
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Fax | 319-545-4445
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Provider Business Mailing Address
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Address Line | 2411 CORAL COURT SUITE 3 BAKERIS FAMILY CHIROPRACTIC
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City | CORALVILLE
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State | IA
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Zip | 52241
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Country | US
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Telephone | 319-545-4444
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Fax | 319-545-4445
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Authorized Official
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Title or Position | DC SECRETARY
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Name | KARI A BAKERIS
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Credential | DC
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Telephone | 319-545-4444
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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 | 06627
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 06624
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0295949
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License Number State | IA
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