Provider Demographics
NPI:1528037504
Name:GLOAR, CAROL D (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:D
Last Name:GLOAR
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 1:1121 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-4213
Mailing Address - Country:US
Mailing Address - Phone:563-386-8915
Mailing Address - Fax:
Practice Address - Street 1:1000 BRADY ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5214
Practice Address - Country:US
Practice Address - Phone:563-884-5800
Practice Address - Fax:563-884-5470
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00032OtherBLUE CROSS BLUE SHIELD IA
IA00032Medicare ID - Type Unspecified
IAT01244Medicare UPIN