Provider Demographics
NPI:1447595541
Name:DUEHN, JACOB DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:DAVID
Last Name:DUEHN
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:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:KEOSAUQUA
Mailing Address - State:IA
Mailing Address - Zip Code:52565-0561
Mailing Address - Country:US
Mailing Address - Phone:319-293-3402
Mailing Address - Fax:
Practice Address - Street 1:805 1ST ST
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-1097
Practice Address - Country:US
Practice Address - Phone:319-293-3402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor