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General NPI Number Information
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NPI Number | 1699288241
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Entity Type | Organization
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Legal Business Name | BURLINGTON FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 145 W BURLINGTON AVE STE 100
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City | BURLINGTON
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State | IA
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Zip | 52601-1914
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Country | US
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Telephone | 319-208-9456
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Fax | 319-208-9456
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Provider Business Mailing Address
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Address Line | 145 W BURLINGTON AVE STE 100
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City | BURLINGTON
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State | IA
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Zip | 52601-1914
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Country | US
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Telephone | 319-289-9456
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Fax | 319-208-9456
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Authorized Official
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Title or Position | OWNER/PRACTICIONER
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Name | DR. RYAN BROCK HATCHER
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Credential | DC
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Telephone | 319-208-9456
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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 | 076576
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License Number State | IA
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