Provider Demographics
NPI:1396875852
Name:BEHN, DUSTIN LAWRENCE (DC)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:LAWRENCE
Last Name:BEHN
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 1:410 YOUNG ST
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:IA
Mailing Address - Zip Code:50648-1195
Mailing Address - Country:US
Mailing Address - Phone:319-827-2045
Mailing Address - Fax:319-827-2045
Practice Address - Street 1:410 YOUNG ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:IA
Practice Address - Zip Code:50648
Practice Address - Country:US
Practice Address - Phone:319-827-2045
Practice Address - Fax:319-827-2045
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7581111N00000X
IA007072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ104703Medicare ID - Type Unspecified