Provider Demographics
NPI:1639144108
Name:RECKER, EMILY P (DC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:RECKER
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 1:216 N MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1748
Mailing Address - Country:US
Mailing Address - Phone:319-465-2060
Mailing Address - Fax:319-465-7022
Practice Address - Street 1:216 N MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1748
Practice Address - Country:US
Practice Address - Phone:319-465-2060
Practice Address - Fax:319-465-7022
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2192489OtherFIRST HEALTH
IA240394OtherMIDLANDS CHOICE #
IA42905OtherBC/BS #
IA0246835Medicaid
IA240394OtherMIDLANDS CHOICE #