Provider Demographics
NPI:1114960226
Name:LETTMAN, GREGORY DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DEAN
Last Name:LETTMAN
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 1:1900 JFK RD SUITE 2
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3800
Mailing Address - Country:US
Mailing Address - Phone:563-588-9200
Mailing Address - Fax:563-583-6594
Practice Address - Street 1:1900 JFK RD SUITE 2
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3800
Practice Address - Country:US
Practice Address - Phone:563-588-9200
Practice Address - Fax:563-583-6594
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1266155Medicaid
IA09750OtherBLUECROSS/BLUESHIELDS