MEDICARE: DR. ROBERT J VERDOORN 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	A05415	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629067699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J VERDOORN D.C.

Provider Business Mailing Address
First Line	:	7546 HICKMAN RD
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-4621
Country	:	US
Telephone Number	:	515-254-0555
Fax Number	:	515-254-0300

Provider Business Practice Location Address
First Line	:	7546 HICKMAN RD
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-4621
Country	:	US
Telephone Number	:	515-254-0555
Fax Number	:	515-254-0300

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	01/15/2020

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