MEDICARE: DR. NANCY LOUISE GRONEWOLD 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	006986	IA

General Provider Information

NPI Number	:	1932305141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY LOUISE GRONEWOLD D.C.

Provider Business Mailing Address
First Line	:	426 HIGHWAY 1 W
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-4204
Country	:	US
Telephone Number	:	319-887-9000
Fax Number	:	319-887-9002

Provider Business Practice Location Address
First Line	:	426 HIGHWAY 1 W
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-4204
Country	:	US
Telephone Number	:	319-887-9000
Fax Number	:	319-887-9002

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	04/01/2008

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