Provider Demographics
NPI:1902343155
Name:HAMMER & FORGE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HAMMER & FORGE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SKYLLER
Authorized Official - Middle Name:
Authorized Official - Last Name:STICKFORT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-216-4414
Mailing Address - Street 1:450 SE UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8121
Mailing Address - Country:US
Mailing Address - Phone:515-216-4414
Mailing Address - Fax:515-218-1468
Practice Address - Street 1:450 SE UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8121
Practice Address - Country:US
Practice Address - Phone:515-216-4414
Practice Address - Fax:515-218-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty