Provider Demographics
NPI:1740235753
Name:SPERFSLAGE, KURT MATTHEW (DC)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:MATTHEW
Last Name:SPERFSLAGE
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 1:907 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ACKLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50601
Mailing Address - Country:US
Mailing Address - Phone:641-847-3500
Mailing Address - Fax:641-847-3500
Practice Address - Street 1:907 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:ACKLEY
Practice Address - State:IA
Practice Address - Zip Code:50601
Practice Address - Country:US
Practice Address - Phone:641-847-3500
Practice Address - Fax:641-847-3500
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA695216OtherACN
IA25200OtherWELLMARK
IA0226886Medicaid
IAI1527Medicare ID - Type Unspecified
IA25200OtherWELLMARK