Provider Demographics
NPI:1144675166
Name:NEW SHARON CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:NEW SHARON CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-419-3377
Mailing Address - Street 1:301 S MAIN ST
Mailing Address - Street 2:P.O. BOX 424
Mailing Address - City:NEW SHARON
Mailing Address - State:IA
Mailing Address - Zip Code:50207-9211
Mailing Address - Country:US
Mailing Address - Phone:641-637-2270
Mailing Address - Fax:
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW SHARON
Practice Address - State:IA
Practice Address - Zip Code:50207-9211
Practice Address - Country:US
Practice Address - Phone:641-637-2270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty