Provider Demographics
NPI:1972551265
Name:KROHSE, DAVID RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RYAN
Last Name:KROHSE
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 1:7405 UNIVERSITY AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1343
Mailing Address - Country:US
Mailing Address - Phone:515-309-1217
Mailing Address - Fax:515-309-1494
Practice Address - Street 1:7405 UNIVERSITY AVE
Practice Address - Street 2:STE 1
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1343
Practice Address - Country:US
Practice Address - Phone:515-309-1217
Practice Address - Fax:515-309-1494
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034599111N00000X
IA007009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8860444Medicare PIN