Provider Demographics
NPI:1336105030
Name:JAMES, DAVID L (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:JAMES
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 1:114 MCCURREN DR
Mailing Address - Street 2:APT 10
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057
Mailing Address - Country:US
Mailing Address - Phone:563-927-2073
Mailing Address - Fax:563-927-2460
Practice Address - Street 1:200 N FRANKLIN
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057
Practice Address - Country:US
Practice Address - Phone:563-927-2460
Practice Address - Fax:563-927-2460
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06125111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA41191OtherBYBS
IA41191OtherBYBS
IAI2207Medicare ID - Type Unspecified