Provider Demographics
NPI:1831224237
Name:HAPPEL, DIANE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:MARIE
Last Name:HAPPEL
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 1:3 N 17TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4223
Mailing Address - Country:US
Mailing Address - Phone:515-573-2441
Mailing Address - Fax:515-573-7228
Practice Address - Street 1:3 N 17TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501
Practice Address - Country:US
Practice Address - Phone:515-573-2441
Practice Address - Fax:515-573-7228
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA34800OtherBCBS
IAP00110955OtherRR MEDICARE
IA3237603Medicaid
IA3237603Medicaid
IAI10934Medicare ID - Type Unspecified