Provider Demographics
NPI:1952317307
Name:STEINKE WILCOX, JESSICA KAY (DC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KAY
Last Name:STEINKE WILCOX
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 1:698 BOYSON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233
Mailing Address - Country:US
Mailing Address - Phone:319-364-9500
Mailing Address - Fax:319-393-1035
Practice Address - Street 1:698 BOYSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233
Practice Address - Country:US
Practice Address - Phone:319-364-9500
Practice Address - Fax:319-393-1035
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0258400Medicaid
I5374Medicare ID - Type Unspecified