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General NPI Number Information
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NPI Number | 1669654356
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Entity Type | Organization
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Legal Business Name | HARTZELL FAMILY CHIROPRACTIC, P.L.C.
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 509 ANSBOROUGH AVE STE A
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City | WATERLOO
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State | IA
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Zip | 50701-2139
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Country | US
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Telephone | 319-226-4404
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Fax | 319-226-4406
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Provider Business Mailing Address
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Address Line | 509 ANSBOROUGH AVE STE A
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City | WATERLOO
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State | IA
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Zip | 50701-2139
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Country | US
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Telephone | 319-226-4404
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Fax | 319-226-4406
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JILL ANN HARTZELL
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Credential | D.C.
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Telephone | 319-226-4404
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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 | 06877
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License Number State | IA
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