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General NPI Number Information
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NPI Number | 1962533166
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Entity Type | Organization
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Legal Business Name | TOTAL CARE CHIROPRACTIC LTD
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 40 ARENA WAY STE 1
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-7062
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Country | US
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Telephone | 712-323-1089
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Fax |
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Provider Business Mailing Address
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Address Line | 40 ARENA WAY STE 1
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-7062
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Country | US
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Telephone | 712-323-1089
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENISE WOODS
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Credential | DC
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Telephone | 712-329-1863
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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 | 06689
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License Number State | IA
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