Provider Demographics
NPI:1730526088
Name:ANSPACH, TIFFANY (DC)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:ANSPACH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:ANSPACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2028 E. 38TH ST.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-1807
Mailing Address - Country:US
Mailing Address - Phone:563-344-6060
Mailing Address - Fax:563-344-6061
Practice Address - Street 1:2028 E. 38TH ST.
Practice Address - Street 2:SUITE 2
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-1807
Practice Address - Country:US
Practice Address - Phone:563-344-6060
Practice Address - Fax:563-344-6061
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009753111N00000X
FLCH10737111N00000X
IA075395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0409320Medicaid