Provider Demographics
NPI:1861700338
Name:MEYE, KENNETH ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ALAN
Last Name:MEYE
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 1:3315 JERSEY RIDGE RD
Mailing Address - Street 2:#1124
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2057
Mailing Address - Country:US
Mailing Address - Phone:563-343-8563
Mailing Address - Fax:
Practice Address - Street 1:3315 JERSEY RIDGE RD
Practice Address - Street 2:#1124
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2057
Practice Address - Country:US
Practice Address - Phone:563-343-8563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60170535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor