Provider Demographics
NPI:1285783449
Name:WINSLOW, JOHN 'BRIAN' (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:'BRIAN'
Last Name:WINSLOW
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 1:710 72ND PL
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2415
Mailing Address - Country:US
Mailing Address - Phone:515-371-5115
Mailing Address - Fax:
Practice Address - Street 1:475 S 50TH ST
Practice Address - Street 2:SUITE 700
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-6981
Practice Address - Country:US
Practice Address - Phone:515-371-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06902111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor