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Contact Information

ACTIVE CHIROPRACTIC P C
1001 13TH AVE N
CLINTON, IA52732-3403
 Phone: 563-242-9343
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for ACTIVE CHIROPRACTIC P C

NPI # 1194149203
LBN Legal business name ACTIVE CHIROPRACTIC P C
Authorized official BRIAN DORNBUSH - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/10/2014
Last updated 02/10/2014 - About 12 years ago
Identifiers
IA License # A06166
IA Medicaid 2180513
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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