Provider Demographics
NPI:1174953699
Name:COVERED BRIDGES CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:COVERED BRIDGES CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:ASHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-978-1189
Mailing Address - Street 1:111 N 2ND AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-1601
Mailing Address - Country:US
Mailing Address - Phone:515-978-1189
Mailing Address - Fax:
Practice Address - Street 1:111 N 2ND AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-1601
Practice Address - Country:US
Practice Address - Phone:515-978-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty