Provider Demographics
NPI:1194878066
Name:DREES FAMILY & SPORTS CHIROPRACTIC, INC
Entity type:Organization
Organization Name:DREES FAMILY & SPORTS CHIROPRACTIC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DREES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-961-5202
Mailing Address - Street 1:2007 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-4873
Mailing Address - Country:US
Mailing Address - Phone:515-961-5202
Mailing Address - Fax:515-961-0998
Practice Address - Street 1:2007 N 6TH ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125
Practice Address - Country:US
Practice Address - Phone:515-961-5202
Practice Address - Fax:515-961-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06619111N00000X
IA06676111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI11114Medicare ID - Type UnspecifiedGROUP NUMBER