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NPI Code Detail

MEDICARE: BLUM FAMILY CHIROPRACTIC LLC

MEDICARE: BLUM FAMILY CHIROPRACTIC LLC
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
1111N00000XChiropractor007187IA

General Provider Information

NPI Number : 1902185275
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUM FAMILY CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 516 LAKEWOOD DR
Second Line :
City : CARROLL
State : IA
Zip : 51401-3406
Country : US
Telephone Number : 712-792-4855
Fax Number :
Provider Business Practice Location Address
First Line : 2903 INGERSOLL AVE
Second Line :
City : DES MOINES
State : IA
Zip : 50312-4014
Country : US
Telephone Number : 515-277-2300
Fax Number :
Authorized Official
Title or Position : ORGANIZER
Name : JOSEPH BLUM
Credential :
Telephone Number : 712-792-4855
Provider Enumeration Date : 08/04/2011
Last Update Date : 08/04/2011

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Directions to “BLUM FAMILY CHIROPRACTIC LLC ” Practice Location

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