Provider Demographics
NPI:1003689415
Name:HEDGECOCK, DYLAN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:ROBERT
Last Name:HEDGECOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 SKYVIEW LN NE
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-9582
Mailing Address - Country:US
Mailing Address - Phone:641-777-2053
Mailing Address - Fax:
Practice Address - Street 1:2911 SKYVIEW LN NE
Practice Address - Street 2:
Practice Address - City:SWISHER
Practice Address - State:IA
Practice Address - Zip Code:52338-9582
Practice Address - Country:US
Practice Address - Phone:641-777-2053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA123224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor