Provider Demographics
NPI:1851074181
Name:DELORME, JOSIAH F
Entity type:Individual
Prefix:
First Name:JOSIAH
Middle Name:F
Last Name:DELORME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W 5TH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52801-1421
Mailing Address - Country:US
Mailing Address - Phone:608-931-4307
Mailing Address - Fax:
Practice Address - Street 1:108 W 5TH ST APT 11
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52801-1421
Practice Address - Country:US
Practice Address - Phone:608-931-4307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor