Provider Demographics
NPI:1891300463
Name:AMY L. BLEVINS, DC, LLC
Entity Type:Organization
Organization Name:AMY L. BLEVINS, DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-888-5130
Mailing Address - Street 1:1912 MIDDLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7600
Mailing Address - Country:US
Mailing Address - Phone:563-888-5130
Mailing Address - Fax:563-888-1780
Practice Address - Street 1:1912 MIDDLE RD STE 200
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7600
Practice Address - Country:US
Practice Address - Phone:563-888-5130
Practice Address - Fax:563-888-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty