Provider Demographics
NPI:1831537257
Name:PLOEGER, GREGORY DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DEAN
Last Name:PLOEGER
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 1:417 MAIN ST
Mailing Address - Street 2:# 507
Mailing Address - City:SLATER
Mailing Address - State:IA
Mailing Address - Zip Code:50244-7781
Mailing Address - Country:US
Mailing Address - Phone:712-263-0801
Mailing Address - Fax:
Practice Address - Street 1:1105 W 4TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52802-3512
Practice Address - Country:US
Practice Address - Phone:712-263-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor