Provider Demographics
NPI:1285691360
Name:MEYLOR, WAYNE R (DC)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:R
Last Name:MEYLOR
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 1:400 PLYMOUTH ST SW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3443
Mailing Address - Country:US
Mailing Address - Phone:712-546-5121
Mailing Address - Fax:712-546-5023
Practice Address - Street 1:400 PLYMOUTH ST. SW
Practice Address - Street 2:
Practice Address - City:LEMARS
Practice Address - State:IA
Practice Address - Zip Code:51031
Practice Address - Country:US
Practice Address - Phone:712-546-5121
Practice Address - Fax:712-546-5023
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19773OtherWELLMARK BCBS
IA0197731Medicaid
IA0197731Medicaid