Provider Demographics
NPI:1902356447
Name:VANWERT, ALLISON (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:VANWERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2739 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-3441
Mailing Address - Country:US
Mailing Address - Phone:207-557-6044
Mailing Address - Fax:
Practice Address - Street 1:2739 E HIGH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-3441
Practice Address - Country:US
Practice Address - Phone:207-557-6044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-08
Last Update Date:2016-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor