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General NPI Number Information
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NPI Number | 1992058341
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Entity Type | Organization
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Legal Business Name | KASPERBAUER CHIROPRACTIC
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 1239 73RD ST STE. K
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City | WINDSOR HEIGHTS
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State | IA
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Zip | 50324-1339
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Country | US
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Telephone | 515-274-4444
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Fax | 515-274-2473
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Provider Business Mailing Address
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Address Line | 1239 73RD ST STE. K
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City | WINDSOR HEIGHTS
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State | IA
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Zip | 50324-1339
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Country | US
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Telephone | 515-274-4444
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Fax | 515-274-2473
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Authorized Official
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Title or Position | OWNER
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Name | ROGER J KASPERBAUER
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Credential |
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Telephone | 515-274-4444
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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 | A5174
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License Number State | IA
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