MEDICARE: TL-JST, INC.

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
1	111NX0800X	Orthopedic Chiropractor	A5695	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11784	OTHER	IA	BLUE CROSS / BLUE SHIELD

General Provider Information

NPI Number	:	1508826942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TL-JST, INC.

Provider Business Mailing Address
First Line	:	1750 PRAIRIE VISTA CIR
Second Line	:
City	:	BETTENDORF
State	:	IA
Zip	:	52722-1828
Country	:	US
Telephone Number	:	563-359-1702
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 PRAIRIE VISTA CIR
Second Line	:
City	:	BETTENDORF
State	:	IA
Zip	:	52722-1828
Country	:	US
Telephone Number	:	563-359-1702
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. THOMAS ALAN WICKS
Credential	:	PH.D., D.C.
Telephone Number	:	563-359-1702

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1376477281 — JESELL SOUHRADA MS, RDN, LDN, NDTR
Practice Location Address:

5 HUTTER LN
BETTENDORF, IA
52722-2105

Practice Phone: 815-275-0938
Practice Fax:

1518122670 — LORI ANN PEDERSEN LISW, MAPC
Practice Location Address:

2550 MIDDLE RD STE 300
BETTENDORF, IA
52722-3287

Practice Phone: 319-230-8018
Practice Fax:

1649610791 — CHRISTA KAE MUELL D.C.
Practice Location Address:

3456 HOLIDAY CT STE A
BETTENDORF, IA
52722-3513

Practice Phone: 563-332-7110
Practice Fax: 563-332-7234

1386403152 — AUDREY ELIZABETH KENNEY
Practice Location Address:

912 MIDDLE RD
BETTENDORF, IA
52722-4104

Practice Phone: 563-526-0581
Practice Fax:

1336671593 — SHREY MODI M.D.
Practice Location Address:

4500 UTICA RIDGE RD # SURGERY
BETTENDORF, IA
52722-1626

Practice Phone: 563-742-5300
Practice Fax:

1427053842 — DR. STEVEN J AGUILAR MD
Practice Location Address:

4321 53RD AVE
BETTENDORF, IA
52722-1269

Practice Phone: 563-421-5300
Practice Fax: 563-421-5319

Directions to “TL-JST, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.