Provider Demographics
NPI:1730225228
Name:GIESE, SHERI LU (DC)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:LU
Last Name:GIESE
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 1:465 HIGHWAY 965 S
Mailing Address - Street 2:UNIT C
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9477
Mailing Address - Country:US
Mailing Address - Phone:319-665-8270
Mailing Address - Fax:319-665-8271
Practice Address - Street 1:465 HIGHWAY 965 S
Practice Address - Street 2:UNIT C
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9477
Practice Address - Country:US
Practice Address - Phone:319-665-8270
Practice Address - Fax:319-665-8271
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3212431Medicaid
IA47098OtherBLUE CROSS BLUE SHIELD
IAI8812Medicare PIN