Provider Demographics
NPI:1952301962
Name:FOLEY, DONALD W (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:FOLEY
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-0378
Mailing Address - Country:US
Mailing Address - Phone:563-547-5250
Mailing Address - Fax:
Practice Address - Street 1:127 2ND AVE W
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1517
Practice Address - Country:US
Practice Address - Phone:563-547-5250
Practice Address - Fax:563-547-3743
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0174953Medicaid
IAT01013Medicare UPIN
IA17495Medicare ID - Type Unspecified