Provider Demographics
NPI:1154434504
Name:OUTHIER, JOHN P (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:OUTHIER
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 1:600 S FREMONT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-1539
Mailing Address - Country:US
Mailing Address - Phone:712-215-9165
Mailing Address - Fax:
Practice Address - Street 1:600 S FREMONT ST
Practice Address - Street 2:SUITE B
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-1539
Practice Address - Country:US
Practice Address - Phone:712-215-9165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6297Medicare UPIN
U81893Medicare UPIN