Provider Demographics
NPI:1730419813
Name:BLOYER, KEVIN WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:WILLIAM
Last Name:BLOYER
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 1:2302 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-5106
Mailing Address - Country:US
Mailing Address - Phone:515-964-1969
Mailing Address - Fax:515-964-0748
Practice Address - Street 1:2302 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-5106
Practice Address - Country:US
Practice Address - Phone:515-964-1969
Practice Address - Fax:515-964-0748
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor