Provider Demographics
NPI:1871555391
Name:MEYER, KIRK DOUGLAS (DC)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:DOUGLAS
Last Name:MEYER
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 64
Mailing Address - Street 2:
Mailing Address - City:LOWDEN
Mailing Address - State:IA
Mailing Address - Zip Code:52255
Mailing Address - Country:US
Mailing Address - Phone:563-941-7787
Mailing Address - Fax:563-944-5663
Practice Address - Street 1:305 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:LOWDEN
Practice Address - State:IA
Practice Address - Zip Code:52255
Practice Address - Country:US
Practice Address - Phone:563-941-7787
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA022A05746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0106922Medicaid
13580Medicare ID - Type Unspecified