Provider Demographics
NPI:1881690220
Name:STROVERS, LANCE GREGORY (DC)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:GREGORY
Last Name:STROVERS
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 1:415 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1955
Mailing Address - Country:US
Mailing Address - Phone:641-236-9355
Mailing Address - Fax:641-236-9357
Practice Address - Street 1:415 6TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1955
Practice Address - Country:US
Practice Address - Phone:641-236-9355
Practice Address - Fax:641-236-9357
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0451427Medicaid
IA37881OtherBLUE CROSS & BLUE SHIELD
IAI14381Medicare ID - Type Unspecified