=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407050651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREW CHIROPRACTIC INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2007
-----------------------------------------------------
Last Update Date | 12/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2451 CORAL CT STE 2
-----------------------------------------------------
City | CORALVILLE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52241-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-337-2335
-----------------------------------------------------
Fax | 319-249-2808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2411 2ND ST STE 1
-----------------------------------------------------
City | CORALVILLE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52241-1500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-337-2335
-----------------------------------------------------
Fax | 319-337-2353
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. CARTER JEFFREY CAREW
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 319-337-2335
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NX0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Chiropractor
-----------------------------------------------------
License Number | A05429
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------