Provider Demographics
NPI:1912642257
Name:RIDGWAY, ALLISON I (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:I
Last Name:RIDGWAY
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 1:5525 MERLE HAY RD STE 165
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1446
Mailing Address - Country:US
Mailing Address - Phone:515-212-5715
Mailing Address - Fax:
Practice Address - Street 1:5525 MERLE HAY RD STE 165
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1446
Practice Address - Country:US
Practice Address - Phone:515-212-5715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA110518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor