Provider Demographics
NPI:1770533382
Name:TURNER, MARITA A (DC)
Entity type:Individual
Prefix:
First Name:MARITA
Middle Name:A
Last Name:TURNER
Suffix:
Gender:F
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:PO BOX 908
Mailing Address - Street 2:401 1/2 E STREET
Mailing Address - City:SERGEANT BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:51054-0908
Mailing Address - Country:US
Mailing Address - Phone:712-943-1550
Mailing Address - Fax:
Practice Address - Street 1:401 1/2 E STREET
Practice Address - Street 2:
Practice Address - City:SERGEANT BLUFF
Practice Address - State:IA
Practice Address - Zip Code:51054-0908
Practice Address - Country:US
Practice Address - Phone:712-943-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA350049464OtherRAILROAD MEDICARE
IA24231OtherBLUE CROSS BLUE SHIELD
IAI0820Medicare PIN
IA24231OtherBLUE CROSS BLUE SHIELD