Organization
EVANSDALE CHIROPRACTIC CLINIC, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE A WIDEN D.C./DI BCN (OWNER)
(319) 234-4872
Entity
Organization
Contact information
Practice address
209 S EVANS RD, EVANSDALE, IA 50707-1121
(319) 234-4872
(319) 236-0670
Mailing address
209 S EVANS RD, EVANSDALE, IA 50707-1121
(319) 234-4872
(319) 236-0670
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5374
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0287854
—
IA
Enumeration date
06/29/2006
Last updated
02/03/2015
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