Organization
FUNCTIONAL CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A ELBERT D.C. (OWNER)
(515) 232-9075
Entity
Organization
Contact information
Practice address
329 W WALNUT ST, OGDEN, IA 50212-3048
(515) 232-9075
Mailing address
329 W WALNUT ST, OGDEN, IA 50212-3048
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04631
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155598
—
IA
01
—
1285608620
INDIVIDUAL NPI
—
Enumeration date
09/26/2011
Last updated
09/26/2011
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