Provider Demographics
NPI:1942270236
Name:KUENY, GREGORY A (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:KUENY
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 1:10 LAKE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALTA
Mailing Address - State:IA
Mailing Address - Zip Code:51002-1244
Mailing Address - Country:US
Mailing Address - Phone:712-200-3846
Mailing Address - Fax:712-200-3847
Practice Address - Street 1:10 LAKE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALTA
Practice Address - State:IA
Practice Address - Zip Code:51002-1244
Practice Address - Country:US
Practice Address - Phone:712-200-3846
Practice Address - Fax:712-200-3847
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02206291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2204057Medicaid
IAU79014Medicare UPIN
IA2204057Medicaid