Provider Demographics
NPI:1336199298
Name:BENTLEY, NEAL JAMES (DC)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:JAMES
Last Name:BENTLEY
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 1:501 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6008
Mailing Address - Country:US
Mailing Address - Phone:515-233-9800
Mailing Address - Fax:
Practice Address - Street 1:501 MAIN ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6008
Practice Address - Country:US
Practice Address - Phone:515-233-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO5511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA072428OtherHEALTH ALLIANCE
IA1247767Medicaid
IA43632OtherBLUE CROSS BLUE SHIELD
IAI5125Medicare ID - Type Unspecified