Provider Demographics
NPI:1407842743
Name:WEHRSPAN, KIRK LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:LYNN
Last Name:WEHRSPAN
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 1:924 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-3709
Mailing Address - Country:US
Mailing Address - Phone:515-224-9999
Mailing Address - Fax:515-224-2338
Practice Address - Street 1:924 4TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-3709
Practice Address - Country:US
Practice Address - Phone:515-224-9999
Practice Address - Fax:515-224-2338
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0148171Medicaid
IA0148171Medicaid
IA56631Medicare ID - Type Unspecified