DOC'S BODY SHOP, PLLC (NPI# 1710510896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710510896 |
| Entity Type | Organization |
| Organization Name | DOC'S BODY SHOP, PLLC |
| Other Organization Name | DOC'S BODY SHOP |
| Practice Address |
2319 S 19th St Clinton IA 52732-6835 |
| Practice Telephone | 5632596173 |
| Practice Fax Number | 5633262046 |
| Mailing Telephone | 5632596173 |
| Mailing Fax Number | 5633262046 |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | DR. REESE RAYMOND PETERSEN (SOLE MEMBER/OWNER) |
| Authorized Official Telephone | 5632596173 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Doc's Body Shop | Doing Business As Name - Organization |
| Pinnacle Pain & Performance Care | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | DOC'S BODY SHOP, PLLC | 2319 S 19th St, Clinton, IA 52732 |
| Street Address |
2319 S 19TH ST |
| City | CLINTON |
| State | IA |
| Zip Code | 52732-6835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942619713 | Reese Raymond Petersen | Chiropractor | 2319 S 19th St, Clinton, IA 52732 | 2014-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343240 | Janet R Graf | Technician | 450 South 19th St., Clinton, IA 52732 | 2019-08-29 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1053835256 | Linda Karina Garcia | Physician Assistant | 1410 N Fourth St, Clinton, IA 52732 | 2017-07-29 |
| 1821528423 | Tricia Lee Grimes | Technician | 2349 Dunham St, Clinton, IA 52732 | 2017-06-15 |
| 1750822425 | Danielle Judd | Skilled Nursing Facility | 2220 N 5th St, Clinton, IA 52732 | 2017-03-15 |
| 1689047185 | Connell Family Chiropractic Pllc | Chiropractor | 1485 Main Avenue, Clinton, IA 52732 | 2015-11-05 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1275829921 | Rebecca Plante | Pharmacist | 1309 N 2nd Street, Clinton, IA 52732 | 2011-06-21 |
| 1639318363 | Ryan P Connell | Chiropractor | 1437 Main Ave, Clinton, IA 52732 | 2009-02-19 |
| 1821218983 | Pathway Living Center, Inc | Community/Behavioral Health | 562 2nd Ave S, Clinton, IA 52732 | 2007-04-30 |
| Find all providers in zip 52732 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558912030 | Morgan Jean Hickman | Chiropractor | 211 S Quincy St, Clinton, IL 61727-1953 | 2019-09-25 |
| 1699244871 | Pinnacle Integrative Healthcare, Pllc | Chiropractor | 2418 S 18th St, Clinton, IA 52732-6827 | 2018-11-17 |
| 1437627734 | Ashley Lynn Susie | Chiropractor | 3008 Lincoln Way Ste B, Clinton, IA 52732-7240 | 2018-11-05 |
| 1609342609 | Warren Chiropractic & Wellness Clinic, LLC | Chiropractor | 244 Highway 65 N Ste 1, Clinton, AR 72031-6677 | 2018-10-17 |
| 1609390699 | Abundant Health Chiropractic LLC | Chiropractor | 90 Beaver Ave Ste 302, Clinton, NJ 08809-1017 | 2017-08-01 |
| 1699204180 | Resurgencepro | Chiropractor | 1641 N 2475 W, Clinton, UT 84015-8237 | 2017-06-08 |
| 1689047185 | Connell Family Chiropractic Pllc | Chiropractor | 1485 Main Avenue, Clinton, IA 52732 | 2015-11-05 |
| 1942619713 | Reese Raymond Petersen | Chiropractor | 2319 S 19th St, Clinton, IA 52732 | 2014-08-06 |
| 1154739621 | Melissa Peters | Chiropractor | 2344 Camanche Ave, Clinton, IA 52732-6034 | 2014-07-29 |
| 1912335860 | Clinton Back and Neck Family Wellness, PC | Chiropractor | 951 13th Ave N, Clinton, IA 52732-5032 | 2013-10-30 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.