MEDICARE: ROBERT J VERDOORN PC

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

General Provider Information

NPI Number	:	1851561765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT J VERDOORN PC

Provider Business Mailing Address
First Line	:	7546 HICKMAN RD
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50322-4621
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	:	50322-4621
Country	:	US
Telephone Number	:	515-254-0555
Fax Number	:	515-254-0300

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT J VERDOORN
Credential	:	DC
Telephone Number	:	515-254-0555

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	03/06/2008

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