Provider Demographics
NPI:1467729228
Name:HOMMER, DANIELLE NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:NICOLE
Last Name:HOMMER
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 1:2201 W 1ST ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2484
Mailing Address - Country:US
Mailing Address - Phone:515-964-8547
Mailing Address - Fax:515-964-8563
Practice Address - Street 1:2201 W 1ST ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2484
Practice Address - Country:US
Practice Address - Phone:515-964-8547
Practice Address - Fax:515-964-8563
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor