Healthcare Provider Details

I. General information

NPI: 1396569612
Provider Name (Legal Business Name): KATELYN AUDREY MENDINI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 17TH ST STE E
BETTENDORF IA
52722-4907
US

IV. Provider business mailing address

321 17TH ST STE E
BETTENDORF IA
52722-4907
US

V. Phone/Fax

Practice location:
  • Phone: 563-265-1842
  • Fax:
Mailing address:
  • Phone: 563-265-1842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number139128
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: