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General NPI Number Information
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NPI Number | 1659222313
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Entity Type | Organization
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Legal Business Name | QUAD CITIES INTEGRATIVE WELLNESS, LLC
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 4622 PROGRESS DR STE A
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City | DAVENPORT
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State | IA
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Zip | 52807-3426
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Country | US
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Telephone | 563-594-6106
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Fax |
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Provider Business Mailing Address
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Address Line | 4622 PROGRESS DR STE A
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City | DAVENPORT
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State | IA
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Zip | 52807-3426
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Country | US
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Telephone | 563-594-6106
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | TARA KINNEY
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Credential | CRNA
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Telephone | 507-254-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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