Organization
BACK CARE OF SPIRIT LAKE, INC.
Active
Other names
Back Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY J. SHELL (CLINIC ADMINISTRATOR)
(712) 336-5311
Entity
Organization
Contact information
Practice address
2309 23RD ST., SPIRIT LAKE, IA 51360-0342
(712) 336-5320
(712) 336-0020
Mailing address
2309 23RD ST., SPIRIT LAKE, IA 51360-0342
(712) 336-5320
(712) 336-0020
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0496174
—
IA
Enumeration date
04/11/2006
Last updated
11/15/2007
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