Provider Demographics
NPI:1902121627
Name:PUGSCHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:PUGSCHIROPRACTIC PLLC
Other - Org Name:BACK TO HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:JOHANNA
Authorized Official - Last Name:ALBERY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-505-6399
Mailing Address - Street 1:210 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:IA
Mailing Address - Zip Code:52747-9622
Mailing Address - Country:US
Mailing Address - Phone:563-505-6399
Mailing Address - Fax:
Practice Address - Street 1:210 5TH ST
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:IA
Practice Address - Zip Code:52747-9622
Practice Address - Country:US
Practice Address - Phone:563-505-6399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty