Provider Demographics
NPI:1144399544
Name:CRAIN, DALE E (DC)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:E
Last Name:CRAIN
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 1:213 W SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2420
Mailing Address - Country:US
Mailing Address - Phone:515-961-9111
Mailing Address - Fax:515-961-5440
Practice Address - Street 1:909 E 2ND AVE
Practice Address - Street 2:SUITE F
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-2892
Practice Address - Country:US
Practice Address - Phone:515-961-9111
Practice Address - Fax:515-961-5440
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA11A05403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor