Provider Demographics
NPI:1558694547
Name:DREYER CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:DREYER CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:DREYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-263-3155
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-0323
Mailing Address - Country:US
Mailing Address - Phone:712-263-3155
Mailing Address - Fax:712-263-3134
Practice Address - Street 1:203 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-1373
Practice Address - Country:US
Practice Address - Phone:712-263-3155
Practice Address - Fax:712-263-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0144816Medicaid
IA0144816Medicaid