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Organization
THOMAS J. ORTH, D.C.P.C.
Active
Organization
THOMAS J. ORTH, D.C.P.C.
Active
Other names
Orth Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
KANDACE K ORTH (BUS/ADM)
(712) 323-0400
Entity
Organization
Contact information
Practice address
1702 W BROADWAY, SUITE 7, COUNCIL BLUFFS, IA 51501
(712) 323-0400
Mailing address
1702 W BROADWAY, SUITE 7, COUNCIL BLUFFS, IA 51501
(712) 323-0400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0415513
—
IA
05
—
1259325
—
IA
01
—
25932
WELLMARK BCBS
—
01
—
DG1488
RR MEDICARE GROUP
—
01
—
I7581
MEDICARE
IA
01
—
I7582
MEDICARE
IA
Enumeration date
08/20/2007
Last updated
11/14/2007
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