Provider Demographics
NPI:1750494043
Name:HARNEY, GARY E (DC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:E
Last Name:HARNEY
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 1:1935 1ST AVE SE
Mailing Address - Street 2:SUITE D
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5332
Mailing Address - Country:US
Mailing Address - Phone:319-362-3350
Mailing Address - Fax:319-365-1211
Practice Address - Street 1:1935 1ST AVE SE
Practice Address - Street 2:SUITE D
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5332
Practice Address - Country:US
Practice Address - Phone:319-362-3350
Practice Address - Fax:319-365-1211
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO5723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1111278Medicaid
IA1111278Medicaid
?Medicare UPIN