Provider Demographics
NPI:1104899228
Name:ALCOTT, HAROLD IVAN (DC)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:IVAN
Last Name:ALCOTT
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 1:502 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:IA
Mailing Address - Zip Code:52208-2026
Mailing Address - Country:US
Mailing Address - Phone:319-444-3515
Mailing Address - Fax:
Practice Address - Street 1:502 8TH ST
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:IA
Practice Address - Zip Code:52208-2026
Practice Address - Country:US
Practice Address - Phone:319-444-3515
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA04033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAT00318Medicare UPIN
IA02580Medicare ID - Type Unspecified