Provider Demographics
NPI:1184810772
Name:BOELGER, LYNN MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:MARIE
Last Name:BOELGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:BOELGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2542 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-1520
Mailing Address - Country:US
Mailing Address - Phone:563-210-8456
Mailing Address - Fax:563-293-7570
Practice Address - Street 1:2542 E 46TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-1520
Practice Address - Country:US
Practice Address - Phone:563-210-8456
Practice Address - Fax:563-293-7570
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05200111N00000X, 111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist