Provider Demographics
NPI:1528047255
Name:SELLERS, MAGGIE A (DC)
Entity type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:A
Last Name:SELLERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 BOYSON RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233
Mailing Address - Country:US
Mailing Address - Phone:319-393-7744
Mailing Address - Fax:
Practice Address - Street 1:698 BOYSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1216
Practice Address - Country:US
Practice Address - Phone:319-393-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA43909OtherWELLMARK BLUE CROSS
IA0295436Medicaid
IAU90404Medicare UPIN