Provider Demographics
NPI:1548402027
Name:BLUM, DAVID GARELD (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GARELD
Last Name:BLUM
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 1:2903 INGERSOLL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-4014
Mailing Address - Country:US
Mailing Address - Phone:712-830-2585
Mailing Address - Fax:
Practice Address - Street 1:120 S FILLMORE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1201
Practice Address - Country:US
Practice Address - Phone:641-342-4455
Practice Address - Fax:641-342-4405
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor