Provider Demographics
NPI:1033213590
Name:VENKER, JOYCE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ANN
Last Name:VENKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 18TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3279
Mailing Address - Country:US
Mailing Address - Phone:563-359-8813
Mailing Address - Fax:563-355-8912
Practice Address - Street 1:2407 18TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3279
Practice Address - Country:US
Practice Address - Phone:563-359-8813
Practice Address - Fax:563-355-8912
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2015-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO5754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42-1413532OtherFEDERAL TAX I.D. NUMBER
IA0134676Medicaid
IA42-1413532OtherFEDERAL TAX I.D. NUMBER