Organization Name: | CCC PC |
NPI Number: | 1740290907 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLI S CONFER (PRESIDENT OWNER) |
Mailing Address: | 404 N 5th St P.o. 407 Red Oak |
State: | IA US |
Postal Code: | 515662323 |
Phone Number: | 7126233526 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 05/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 06364 |
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. |