Provider Demographics
NPI:1760483341
Name:GRAUER, CONNIE C (DC)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:C
Last Name:GRAUER
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 1:11 GLEASON DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-5854
Mailing Address - Country:US
Mailing Address - Phone:319-358-1844
Mailing Address - Fax:319-358-1844
Practice Address - Street 1:1214 1/2 S GILBERT ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4506
Practice Address - Country:US
Practice Address - Phone:319-358-1844
Practice Address - Fax:319-358-1844
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0296806Medicaid
IA45193OtherWELLMARK
U89991Medicare UPIN
IA45193OtherWELLMARK