Provider Demographics
NPI:1336488170
Name:CIRKS, MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:CIRKS
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 1:1146 190TH ST
Mailing Address - Street 2:
Mailing Address - City:BRADGATE
Mailing Address - State:IA
Mailing Address - Zip Code:50520-8710
Mailing Address - Country:US
Mailing Address - Phone:515-368-0086
Mailing Address - Fax:
Practice Address - Street 1:1201 6TH AVE N
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:IA
Practice Address - Zip Code:50548-1102
Practice Address - Country:US
Practice Address - Phone:515-368-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor