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General NPI Number Information
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NPI Number | 1558999516
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Entity Type | Organization
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Legal Business Name | SUSIE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 3008 LINCOLN WAY STE B
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City | CLINTON
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State | IA
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Zip | 52732-7240
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Country | US
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Telephone | 563-503-4255
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Fax |
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Provider Business Mailing Address
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Address Line | 3008 LINCOLN WAY STE B
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City | CLINTON
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State | IA
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Zip | 52732-7240
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Country | US
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Telephone | 563-503-4255
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ASHLEY LYNN SUSIE
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Credential | DC
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Telephone | 563-503-4255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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