Provider Demographics
NPI:1588630396
Name:POHLMAN, KORY J (DC)
Entity Type:Individual
Prefix:
First Name:KORY
Middle Name:J
Last Name:POHLMAN
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 1:7450 BRIDGEWOOD BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8112
Mailing Address - Country:US
Mailing Address - Phone:515-221-0883
Mailing Address - Fax:515-221-0885
Practice Address - Street 1:7450 BRIDGEWOOD BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8112
Practice Address - Country:US
Practice Address - Phone:515-221-0883
Practice Address - Fax:515-221-0885
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA03162OtherBLUE CROSS BLUE SHIELD
IA1460071Medicaid
IA1460071Medicaid