Provider Demographics
NPI:1376767814
Name:CRETSINGER, W. GENE (DC)
Entity Type:Individual
Prefix:DR
First Name:W.
Middle Name:GENE
Last Name:CRETSINGER
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 1:3800 RIVER RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-7530
Mailing Address - Country:US
Mailing Address - Phone:319-393-3996
Mailing Address - Fax:319-393-7187
Practice Address - Street 1:3800 RIVER RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7530
Practice Address - Country:US
Practice Address - Phone:319-393-3996
Practice Address - Fax:319-393-7187
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2026153Medicaid
IA09235OtherWELLMARK BCBS
IA09235OtherWELLMARK BCBS
IAT00328Medicare UPIN