MEDICARE: MIND, BODY & SPIRIT CHIROPRACTIC, 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
1	111N00000X	Chiropractor	007062	IA

General Provider Information

NPI Number	:	1871743005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND, BODY & SPIRIT CHIROPRACTIC, PLC

Provider Business Mailing Address
First Line	:	3804 1ST AVE NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-5603
Country	:	US
Telephone Number	:	319-362-8800
Fax Number	:	319-362-8911

Provider Business Practice Location Address
First Line	:	3804 1ST AVE NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-5603
Country	:	US
Telephone Number	:	319-362-8800
Fax Number	:	319-362-8911

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. LAURA LYNN LEDGER
Credential	:	D.C.
Telephone Number	:	319-362-8800

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	09/24/2008

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