Provider Demographics
NPI:1982703369
Name:DURANT CHIROPRACTIC PC
Entity Type:Organization
Organization Name:DURANT CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GEURINK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:563-785-6511
Mailing Address - Street 1:902 5TH ST
Mailing Address - Street 2:PO BOX 715
Mailing Address - City:DURANT
Mailing Address - State:IA
Mailing Address - Zip Code:52747-7735
Mailing Address - Country:US
Mailing Address - Phone:563-785-6511
Mailing Address - Fax:563-785-6347
Practice Address - Street 1:902 5TH ST
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:IA
Practice Address - Zip Code:52747-7735
Practice Address - Country:US
Practice Address - Phone:563-785-6511
Practice Address - Fax:563-785-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05230111N00000X
IAA05303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10590OtherMIDLANDS CHOICE
25944OtherBLUE CROSS/BLUE SHIELD
IA0104OtherJOHN DEERE HEALTHCARE
P00298398OtherPALMETTO GBA/RR
25944OtherBLUE CROSS/BLUE SHIELD
=========OtherMARSH ADVANTAGE
P00298398OtherPALMETTO GBA/RR