Provider Demographics
NPI:1154396638
Name:HASSEL, VINCENT EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:EDWARD
Last Name:HASSEL
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 1:1349 NW 121ST. ST., SUITE 100
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325
Mailing Address - Country:US
Mailing Address - Phone:515-270-2111
Mailing Address - Fax:515-270-0323
Practice Address - Street 1:1349 NW 121ST. ST., SUITE 100
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325
Practice Address - Country:US
Practice Address - Phone:515-270-2111
Practice Address - Fax:515-270-0323
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA350051728OtherMEDICARE RAILROAD
IA0151290Medicaid
IA58801OtherBLUE CROSS BLUE SHIELD PP
IA58801OtherBLUE CROSS BLUE SHIELD PP