Provider Demographics
NPI:1982675096
Name:HOUG, BRENDA K (DC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:K
Last Name:HOUG
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 1:107 ROSSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WAUKON
Mailing Address - State:IA
Mailing Address - Zip Code:52172-1935
Mailing Address - Country:US
Mailing Address - Phone:563-568-0088
Mailing Address - Fax:563-568-2998
Practice Address - Street 1:107 ROSSVILLE RD
Practice Address - Street 2:
Practice Address - City:WAUKON
Practice Address - State:IA
Practice Address - Zip Code:52172-1935
Practice Address - Country:US
Practice Address - Phone:563-568-0088
Practice Address - Fax:563-568-2998
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU58311Medicare UPIN