Provider Demographics
NPI:1851432009
Name:DIRLAM, LINDA SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SUE
Last Name:DIRLAM
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 1:315 MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2757
Mailing Address - Country:US
Mailing Address - Phone:319-277-5437
Mailing Address - Fax:319-277-3538
Practice Address - Street 1:315 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2757
Practice Address - Country:US
Practice Address - Phone:319-277-5437
Practice Address - Fax:319-277-3538
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0143289Medicaid
IA54805Medicare ID - Type Unspecified