MEDICARE: DR. PAULETTE DEWEERD D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5925	IA

General Provider Information

NPI Number	:	1578549903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULETTE DEWEERD D.C.

Provider Business Mailing Address
First Line	:	203 S UNION ST
Second Line	:
City	:	ROCK RAPIDS
State	:	IA
Zip	:	51246-1337
Country	:	US
Telephone Number	:	712-472-2481
Fax Number	:	712-472-2481

Provider Business Practice Location Address
First Line	:	203 S UNION ST
Second Line	:
City	:	ROCK RAPIDS
State	:	IA
Zip	:	51246-1337
Country	:	US
Telephone Number	:	712-472-2481
Fax Number	:	712-472-2481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2005
Last Update Date	:	08/08/2012

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