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General NPI Number Information
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NPI Number | 1699051029
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Entity Type | Organization
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Legal Business Name | VANDER SLUIS CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 8521 HICKMAN RD
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City | URBANDALE
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State | IA
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Zip | 50322-4321
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Country | US
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Telephone | 515-402-9792
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Fax |
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Provider Business Mailing Address
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Address Line | 8521 HICKMAN RD
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City | URBANDALE
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State | IA
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Zip | 50322-4321
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Country | US
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Telephone | 515-402-9792
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. KARRIE ANN VANDER SLUIS
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Credential | D.C.
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Telephone | 515-402-9792
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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 | 007463
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License Number State | IA
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