Provider Demographics
NPI:1750760989
Name:CHOICE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:CHOICE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SKRENES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-324-5313
Mailing Address - Street 1:712 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-1514
Mailing Address - Country:US
Mailing Address - Phone:712-324-5313
Mailing Address - Fax:712-324-5314
Practice Address - Street 1:712 4TH AVE
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-1514
Practice Address - Country:US
Practice Address - Phone:712-324-5313
Practice Address - Fax:712-324-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077959111N00000X
IA077716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB3386OtherMEDICARE PTAN