Provider Demographics
NPI:1831281104
Name:NEWMYER, TROY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:MICHAEL
Last Name:NEWMYER
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 1:4811 N BRADY ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-3974
Mailing Address - Country:US
Mailing Address - Phone:563-386-8308
Mailing Address - Fax:563-386-4650
Practice Address - Street 1:4811 N BRADY ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-3974
Practice Address - Country:US
Practice Address - Phone:563-386-8308
Practice Address - Fax:563-386-4650
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA49539OtherBCBS
U90826Medicare UPIN