Provider Demographics
NPI:1871524686
Name:DROVER, MICHELLE R (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:R
Last Name:DROVER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:R
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1000 BRADY ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-5214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:563-884-5470
Practice Address - Street 1:1000 BRADY ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5214
Practice Address - Country:US
Practice Address - Phone:563-884-5000
Practice Address - Fax:563-884-5731
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010555111N00000X
IA06803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA223920005Medicare Oscar/Certification
U82832Medicare UPIN
OH2205312Medicaid
OHBA4037823Medicare ID - Type Unspecified