Provider Demographics
NPI:1285693754
Name:HANDELAND, MICHAEL STEVEN (DC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:HANDELAND
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:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536-0091
Mailing Address - Country:US
Mailing Address - Phone:712-852-2266
Mailing Address - Fax:712-852-3728
Practice Address - Street 1:3687 450TH AVE
Practice Address - Street 2:
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536
Practice Address - Country:US
Practice Address - Phone:712-852-2266
Practice Address - Fax:712-852-3728
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0157727Medicaid
IA40259OtherBCBS OF IA
IA40259OtherBCBS OF IA
IA40259Medicare ID - Type Unspecified