| NPI | 1578996294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PAULETTE KELLY Owner 319-233-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 06386) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: IA 06386) |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: IA 06386) | |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2014-12-04 |