Provider Demographics
NPI:1356396899
Name:MIER, WENDY LYNNAE (DC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LYNNAE
Last Name:MIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:LYNNAE
Other - Last Name:MCCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1205 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632-2988
Mailing Address - Country:US
Mailing Address - Phone:712-542-3056
Mailing Address - Fax:712-542-3056
Practice Address - Street 1:1205 S 16TH ST
Practice Address - Street 2:
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632-2988
Practice Address - Country:US
Practice Address - Phone:712-542-3056
Practice Address - Fax:712-542-3056
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA24122OtherWELLMARK BCBS OF IOWA
IA205319031OtherUNITED HEALTH CARE
IA2209130Medicaid
IAI21184Medicare UPIN
IA24122OtherWELLMARK BCBS OF IOWA