Provider Demographics
NPI:1134337637
Name:FLATIN, CHERYL LEANN (DC)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LEANN
Last Name:FLATIN
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 1:801 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2344
Mailing Address - Country:US
Mailing Address - Phone:563-382-2400
Mailing Address - Fax:
Practice Address - Street 1:801 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2344
Practice Address - Country:US
Practice Address - Phone:563-382-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA5274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00234Medicare ID - Type Unspecified
IAT61913Medicare UPIN