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General NPI Number Information
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NPI Number | 1669603254
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Entity Type | Organization
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Legal Business Name | BACK IN LINE FAMILY CHIROPRACTIC AND WELLNESS, P.C.
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Dates
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Enumeration Date | 07/31/2009
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 1212 DINA CT
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City | HIAWATHA
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State | IA
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Zip | 52233-4706
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Country | US
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Telephone | 319-892-3363
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Fax | 319-892-3034
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Provider Business Mailing Address
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Address Line | 102 A AVE
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City | HIAWATHA
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State | IA
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Zip | 52233-1504
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Country | US
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Telephone | 319-892-3363
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Fax | 319-892-3034
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Authorized Official
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Title or Position | OWNER
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Name | DR. CALLA JAYNE H KLEENE
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Credential | D.C.
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Telephone | 319-892-3034
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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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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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