Organization
BURT CLINIC OF CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY BURT DC (OWNER OPERATOR)
(563) 284-6927
Entity
Organization
Contact information
Practice address
790 N MAIN ST, WALCOTT, IA 52773-9505
(563) 284-6927
(563) 284-6398
Mailing address
PO BOX 790, 790 N MAIN ST, WALCOTT, IA 52773-0790
(563) 284-6927
(563) 284-6398
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04377
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122689
—
IA
Enumeration date
02/08/2007
Last updated
01/10/2013
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