Provider Demographics
NPI:1699745661
Name:WALDING, PATRICK A (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:WALDING
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 1:3133 FLOYD BLVD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51108-1419
Mailing Address - Country:US
Mailing Address - Phone:712-239-2700
Mailing Address - Fax:712-239-2702
Practice Address - Street 1:3133 FLOYD BLVD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51108-1419
Practice Address - Country:US
Practice Address - Phone:712-239-2700
Practice Address - Fax:712-239-2702
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1078733Medicaid
NE1002503060Medicaid
IA16587OtherBCBS
IA22490OtherSIOUX VALLEY HEALTH PLAN
NE1002503060Medicaid
IA1078733Medicaid