Provider Demographics
NPI:1104581420
Name:IRWIN, ANGELA (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:IRWIN
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 1:3511 43RD ST
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5522
Mailing Address - Country:US
Mailing Address - Phone:517-740-1924
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 60S
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3584
Practice Address - Country:US
Practice Address - Phone:563-277-4043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA110688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor