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General NPI Number Information
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NPI Number | 1508207184
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Entity Type | Organization
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Legal Business Name | J P OUTHIER P C
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 600 S FREMONT ST SUITE B
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City | SHENANDOAH
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State | IA
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Zip | 51601-1539
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Country | US
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Telephone | 515-326-5540
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Fax |
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Provider Business Mailing Address
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Address Line | 600 S FREMONT ST SUITE B
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City | SHENANDOAH
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State | IA
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Zip | 51601-1539
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Country | US
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Telephone | 515-326-5540
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN PHILIP OUTHIER
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Credential | D.C.
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Telephone | 515-326-1310
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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 | 6297
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License Number State | IA
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