| NPI | 1164703039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK JAMES BENNER President 319-243-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 007451) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: IA 007451) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2011-09-06 |