Provider Demographics
NPI:1124072897
Name:LIPES, DANNY G (DC)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:G
Last Name:LIPES
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 1:3719 BRIDGE AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807
Mailing Address - Country:US
Mailing Address - Phone:563-344-6060
Mailing Address - Fax:563-344-6061
Practice Address - Street 1:3719 BRIDGE AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807
Practice Address - Country:US
Practice Address - Phone:563-344-6060
Practice Address - Fax:563-344-6061
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0263673Medicaid
U68529Medicare UPIN
IA41563Medicare PIN
IA0263673Medicaid