Provider Demographics
NPI:1003994211
Name:AUDLEHELM, JAMES EDWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWIN
Last Name:AUDLEHELM
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:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-0461
Mailing Address - Country:US
Mailing Address - Phone:641-342-4022
Mailing Address - Fax:641-342-4022
Practice Address - Street 1:430 S TEMPLE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1515
Practice Address - Country:US
Practice Address - Phone:641-342-4022
Practice Address - Fax:641-342-4022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0006981Medicaid
IA00698OtherWELLMARK
IA00698OtherWELLMARK
IA00698Medicare ID - Type Unspecified