Provider Demographics
NPI:1083703813
Name:HARTER, ALLYN H (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLYN
Middle Name:H
Last Name:HARTER
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 1:3944 PARTRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2291
Mailing Address - Country:US
Mailing Address - Phone:563-332-5595
Mailing Address - Fax:
Practice Address - Street 1:1914 16TH ST
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-3953
Practice Address - Country:US
Practice Address - Phone:309-762-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor