Provider Demographics
NPI:1235126848
Name:EISENMANN, EMILY K (DC)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:K
Last Name:EISENMANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 AGENCY ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-1908
Mailing Address - Country:US
Mailing Address - Phone:319-752-1460
Mailing Address - Fax:319-752-1461
Practice Address - Street 1:3115 AGENCY ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-1908
Practice Address - Country:US
Practice Address - Phone:319-752-1460
Practice Address - Fax:319-752-1461
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1164550547Medicaid
IA1164550547Medicare PIN