Provider Demographics
NPI:1497748164
Name:DR. LYNN I. LABBE, P.C.
Entity Type:Organization
Organization Name:DR. LYNN I. LABBE, P.C.
Other - Org Name:LINN-MAR CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:BANDEROB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-377-1234
Mailing Address - Street 1:3250 10TH AVE
Mailing Address - Street 2:STE. 1
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-1507
Mailing Address - Country:US
Mailing Address - Phone:319-377-1234
Mailing Address - Fax:319-377-1930
Practice Address - Street 1:3250 10TH AVE
Practice Address - Street 2:STE. 1
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-1507
Practice Address - Country:US
Practice Address - Phone:319-377-1234
Practice Address - Fax:319-377-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0483743Medicaid
IA49109OtherWELLMARK BLUECROSS BLUESH
IA0483743Medicaid
IA49109OtherWELLMARK BLUECROSS BLUESH