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Organization

SHIPMAN CHIROPRACTIC & WELLNESS CLINIC LLC

Active
Parent organization
SHIPMAN CHIROPRACTIC & WELLNESS CLINIC LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SHIPMAN CHIROPRACTIC & WELLNESS CLINIC LLC
Authorized official
LACY M SKAHILL (CLINIC DIRECTOR)
(563) 359-1985
Entity
Organization

Contact information

Practice address
4557 UTICA RIDGE RD, BETTENDORF, IA 52722-1641
(563) 359-1985
(563) 355-2300
Mailing address
4557 UTICA RIDGE RD, BETTENDORF, IA 52722-1641
(563) 359-1985
(563) 355-2300

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
208D00000X
General Practice Physician
261Q00000X
Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0498170
IA
05
1104778
IA
01
19257
BLUE CROSS BLUE SHEILD
IA
01
I9004
MEDICARE PIN
IA
01
U45391
MEDICARE UPIN
IA
Enumeration date
11/08/2019
Last updated
11/08/2019
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