Provider Demographics
NPI:1932197126
Name:HILL, HENRY RONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:RONALD
Last Name:HILL
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 1:602 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:IA
Mailing Address - Zip Code:52742-1124
Mailing Address - Country:US
Mailing Address - Phone:563-659-8155
Mailing Address - Fax:563-659-3520
Practice Address - Street 1:602 12TH ST
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:IA
Practice Address - Zip Code:52742-1124
Practice Address - Country:US
Practice Address - Phone:563-659-8155
Practice Address - Fax:563-659-3520
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0094433Medicaid
IAI15224Medicare ID - Type UnspecifiedPROVIDER NUMBER
IA0094433Medicaid