Provider Demographics
NPI:1851358543
Name:CROSS, ANGELA LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LOUISE
Last Name:CROSS
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 1:715 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2569
Mailing Address - Country:US
Mailing Address - Phone:712-792-4600
Mailing Address - Fax:712-792-7775
Practice Address - Street 1:715 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2569
Practice Address - Country:US
Practice Address - Phone:712-792-4600
Practice Address - Fax:712-792-7775
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0435560Medicaid
IA0435560Medicaid
IAU99510Medicare UPIN