Provider Demographics
NPI:1649319831
Name:HOWARD, CYNTHIA LORRAINE (BS, DC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LORRAINE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:LORRAINE
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS,DC
Mailing Address - Street 1:121 S MISSISSIPPI ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-9306
Mailing Address - Country:US
Mailing Address - Phone:563-505-1127
Mailing Address - Fax:563-484-5304
Practice Address - Street 1:121 S MISSISSIPPI ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BLUE GRASS
Practice Address - State:IA
Practice Address - Zip Code:52726-9306
Practice Address - Country:US
Practice Address - Phone:563-505-1127
Practice Address - Fax:563-484-5304
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0746818Medicaid
IAI19577Medicare PIN