Dietrich Chiropractic Pc | |
1605 W Kimberly Rd, Davenport, IA 52806-5532 | |
(563) 386-4798 | |
(563) 386-0903 |
Full Name | Dietrich Chiropractic Pc |
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Type | Facility |
Speciality | Chiropractor |
Location | 1605 W Kimberly Rd, Davenport, Iowa |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568508000 | NPI | - | NPPES |
0488312 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | L Anthony Dietrich |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1093707911 PECOS PAC ID: 5698769420 Enrollment ID: I20060407000081 |
Mailing Address | Practice Location Address |
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Dietrich Chiropractic Pc 1605 W Kimberly Rd, Davenport, IA 52806-5532 Ph: (563) 386-4798 | Dietrich Chiropractic Pc 1605 W Kimberly Rd, Davenport, IA 52806-5532 Ph: (563) 386-4798 |
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