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General NPI Number Information
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NPI Number | 1487212429
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Entity Type | Organization
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Legal Business Name | APEX CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 302 S HIGHLAND ST
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City | SAINT CHARLES
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State | IA
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Zip | 50240-1519
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Country | US
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Telephone | 641-891-6929
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Fax |
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Provider Business Mailing Address
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Address Line | 302 S HIGHLAND ST
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City | SAINT CHARLES
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State | IA
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Zip | 50240-1519
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Country | US
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Telephone | 641-891-6929
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WYATT TYLER
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Credential | D.C.
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Telephone | 641-891-6929
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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 |
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