Organization
FUNCTION FIRST CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY ALLEN GOODCHILD (OWNER)
(712) 299-5653
Entity
Organization
Contact information
Practice address
307 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-4063
(712) 732-6383
Mailing address
307 W 5TH ST, STORM LAKE, IA 50588-1743
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
089620
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588171920
GROUP
IA
01
—
1801303243
NPI
IA
Enumeration date
01/08/2018
Last updated
05/16/2022
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