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NPI Code Detail

MEDICARE: VIM CHIROPRACTIC AND WELLNESS PLC

MEDICARE: VIM CHIROPRACTIC AND WELLNESS PLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor007551IA

General Provider Information

NPI Number : 1386160349
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIM CHIROPRACTIC AND WELLNESS PLC
Provider Business Mailing Address
First Line : 5300 EDGEWOOD RD NE STE 200
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52411-4706
Country : US
Telephone Number : 319-294-4855
Fax Number :
Provider Business Practice Location Address
First Line : 5300 EDGEWOOD RD NE STE 200
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52411-4706
Country : US
Telephone Number : 319-294-4855
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. SAMANTHA KENNEDY
Credential : D.C
Telephone Number : 319-294-4855
Provider Enumeration Date : 08/21/2017
Last Update Date : 03/03/2020

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Directions to “VIM CHIROPRACTIC AND WELLNESS PLC ” Practice Location

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