Provider Demographics
NPI:1073583712
Name:CHRISTY, REX D (DC)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:D
Last Name:CHRISTY
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 1:415 C AVE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-1150
Mailing Address - Country:US
Mailing Address - Phone:319-472-5239
Mailing Address - Fax:
Practice Address - Street 1:415 C AVE
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-1150
Practice Address - Country:US
Practice Address - Phone:319-472-5239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0204479Medicaid
IA20447OtherBLUE CROSS BLUE SHIELD
IA20447OtherBLUE CROSS BLUE SHIELD
IATO1172Medicare UPIN