Provider Demographics
NPI:1235996877
Name:BLUNK, MADILYN KAYSHA (DC)
Entity Type:Individual
Prefix:
First Name:MADILYN
Middle Name:KAYSHA
Last Name:BLUNK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MADILYN
Other - Middle Name:KAYSHA
Other - Last Name:KESSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:909 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-2427
Mailing Address - Country:US
Mailing Address - Phone:712-269-7825
Mailing Address - Fax:
Practice Address - Street 1:909 4TH AVE S
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-2427
Practice Address - Country:US
Practice Address - Phone:712-263-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA125116111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor