Provider Demographics
NPI:1609187624
Name:JP NEWHOUSE PC
Entity type:Organization
Organization Name:JP NEWHOUSE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:NEWHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-514-7509
Mailing Address - Street 1:3740 EASTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2858
Mailing Address - Country:US
Mailing Address - Phone:563-514-7509
Mailing Address - Fax:563-514-5848
Practice Address - Street 1:2211 E 52ND ST
Practice Address - Street 2:STE. D
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2771
Practice Address - Country:US
Practice Address - Phone:563-514-7509
Practice Address - Fax:563-514-5848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty