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General NPI Number Information
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NPI Number | 1962510230
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Entity Type | Organization
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Legal Business Name | MICHELLE NELSON CHIROPRACTIC INC
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 698 BOYSON RD STE B
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City | HIAWATHA
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State | IA
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Zip | 52233-1216
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Country | US
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Telephone | 319-393-4727
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Fax | 319-393-1035
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Provider Business Mailing Address
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Address Line | 698 BOYSON RD SUITE B
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City | HIAWATHA
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State | IA
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Zip | 52233-1216
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Country | US
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Telephone | 319-393-4727
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Fax | 319-393-1035
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. MICHELLE MARIE NELSON
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Credential | DC
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Telephone | 319-393-4727
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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 | 06393
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License Number State | IA
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