Organization
KEOKUK CHIROPRACTIC & SPORTS INJURY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS E. WOLTER (PRESIDENT)
(319) 524-0905
Entity
Organization
Contact information
Practice address
924 MAIN ST, KEOKUK, IA 52632-4655
(319) 524-0905
Mailing address
924 MAIN ST, KEOKUK, IA 52632-4655
(319) 524-0905
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52935
BCBS
IA
01
—
615537
TRIGON
IA
Enumeration date
01/10/2008
Last updated
01/10/2008
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