Organization Name: | LIFESTREAM CHIROPRACTIC CLINIC |
NPI Number: | 1205279254 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH O'TOOL (MANAGER) |
Mailing Address: | 7195 Nw 54th Ave Urbandale |
State: | IA US |
Postal Code: | 503226915 |
Phone Number: | 5632109128 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2013 |
NPI Last Update Date: | 04/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 007623 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |