Provider Demographics
NPI:1013348143
Name:MEYER, BLAKE (DC)
Entity Type:Individual
Prefix:
First Name:BLAKE
Middle Name:
Last Name:MEYER
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 1:411 LAUREL ST STE 2390
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3070
Mailing Address - Country:US
Mailing Address - Phone:515-243-9287
Mailing Address - Fax:515-243-1722
Practice Address - Street 1:411 LAUREL ST STE 2390
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3070
Practice Address - Country:US
Practice Address - Phone:515-243-9287
Practice Address - Fax:515-243-9287
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007061111N00000X
IA076219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor