Provider Demographics
NPI:1376947630
Name:HERRMANN, MEGAN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MARIE
Last Name:HERRMANN
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 1:6110 NW 86TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2257
Mailing Address - Country:US
Mailing Address - Phone:515-276-4946
Mailing Address - Fax:515-276-6535
Practice Address - Street 1:6110 NW 86TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2257
Practice Address - Country:US
Practice Address - Phone:515-276-4946
Practice Address - Fax:515-276-6535
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA075615111N00000X
OH4460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor