Provider Demographics
NPI:1417976374
Name:MEYER, JEFFREY JAMES (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:JAMES
Last Name:MEYER
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 1:375 COLLINS ROAD NE
Mailing Address - Street 2:SUITE 22
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3168
Mailing Address - Country:US
Mailing Address - Phone:319-395-9897
Mailing Address - Fax:319-395-9891
Practice Address - Street 1:375 COLLINS ROAD NE
Practice Address - Street 2:SUITE 22
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3168
Practice Address - Country:US
Practice Address - Phone:319-395-9897
Practice Address - Fax:319-395-9891
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2137976Medicaid
IA2137976Medicaid
58216Medicare ID - Type Unspecified