Provider Demographics
NPI:1841938321
Name:CLENDENEN, ANNE LOUISE (DC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:LOUISE
Last Name:CLENDENEN
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 1:1706 NE HAYES DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4557
Mailing Address - Country:US
Mailing Address - Phone:515-250-4729
Mailing Address - Fax:
Practice Address - Street 1:96 PAINE CIR STE 3
Practice Address - Street 2:
Practice Address - City:BONDURANT
Practice Address - State:IA
Practice Address - Zip Code:50035-1488
Practice Address - Country:US
Practice Address - Phone:304-552-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor