Provider Demographics
NPI:1164401840
Name:KERR, LOUIS G (DC)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:G
Last Name:KERR
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 1:514 E GEORGE WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-1232
Mailing Address - Country:US
Mailing Address - Phone:563-324-3333
Mailing Address - Fax:563-324-3333
Practice Address - Street 1:514 E GEORGE WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-1232
Practice Address - Country:US
Practice Address - Phone:563-324-3333
Practice Address - Fax:563-324-3333
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05961111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1733Medicare PIN
U62297Medicare UPIN