Provider Demographics
NPI:1609411750
Name:O'BLENESS, ANDREW JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:O'BLENESS
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 1:2200 NW 152ND ST.
Mailing Address - Street 2:STE C
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325
Mailing Address - Country:US
Mailing Address - Phone:319-795-1253
Mailing Address - Fax:
Practice Address - Street 1:2200 NW 152ND ST.
Practice Address - Street 2:STE. C
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325
Practice Address - Country:US
Practice Address - Phone:319-795-1253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty