Organization
MIDWAY CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA SUE PRATT D.C. (DOCTOR OF CHIROPRACTIC)
(563) 890-6275
Entity
Organization
Contact information
Practice address
2021 HIGHWAY 130, BENNETT, IA 52721-9601
(563) 890-6275
Mailing address
2021 HIGHWAY 130, BENNETT, IA 52721-9601
(563) 890-6275
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06817
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0476648
—
IA
01
—
39898
BLUE CROSS BLUE SHIELD
IA
Enumeration date
10/26/2006
Last updated
08/22/2020
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