Provider Demographics
NPI:1700479029
Name:HUSSIEN, HUMAM JASSIM (DC)
Entity Type:Individual
Prefix:
First Name:HUMAM
Middle Name:JASSIM
Last Name:HUSSIEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1905 EP TRUE PKWY
Mailing Address - Street 2:STE 207
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-7056
Mailing Address - Country:US
Mailing Address - Phone:515-309-3791
Mailing Address - Fax:515-309-3792
Practice Address - Street 1:8088 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2450
Practice Address - Country:US
Practice Address - Phone:515-252-7070
Practice Address - Fax:515-225-0123
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA106810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor