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General NPI Number Information
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NPI Number | 1275728784
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Entity Type | Organization
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Legal Business Name | MOUW CHIROPRACTIC & SPINAL REHABILITATION CENTER, P.C.
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 20 POWER DR SUITE 1
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-7701
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Country | US
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Telephone | 712-366-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 20 POWER DR SUITE 1
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-7701
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Country | US
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Telephone | 712-366-1611
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LYNNE A MOUW
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Credential | D.C.
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Telephone | 712-366-1611
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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 |
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License Number State | IA
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