Provider Demographics
NPI:1508049875
Name:DORMAN, MYHRE D (DC)
Entity Type:Individual
Prefix:DR
First Name:MYHRE
Middle Name:D
Last Name:DORMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MYHRE
Other - Middle Name:D
Other - Last Name:SHAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:706 S 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:51246-1931
Mailing Address - Country:US
Mailing Address - Phone:712-472-4732
Mailing Address - Fax:712-472-4734
Practice Address - Street 1:706 S 9TH AVE
Practice Address - Street 2:
Practice Address - City:ROCK RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:51246-1931
Practice Address - Country:US
Practice Address - Phone:712-472-4732
Practice Address - Fax:712-472-4734
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5040111N00000X
WI4425-012111N00000X
IA007199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor