Provider Demographics
NPI:1790837284
Name:SHERBONDY, DAVID A (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SHERBONDY
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 1:3612 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-9456
Mailing Address - Country:US
Mailing Address - Phone:319-754-5505
Mailing Address - Fax:319-754-4133
Practice Address - Street 1:3612 WEST AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-9456
Practice Address - Country:US
Practice Address - Phone:319-754-5505
Practice Address - Fax:319-754-4133
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02204082111N00000X
IA04082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAT00218Medicare UPIN
IA01840Medicare PIN