Healthcare Provider Details

I. General information

NPI: 1174345565
Provider Name (Legal Business Name): MADISON KRESS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 2ND ST NE STE C
BONDURANT IA
50035-1336
US

IV. Provider business mailing address

6950 STAGECOACH DR UNIT 902
WEST DES MOINES IA
50266-3895
US

V. Phone/Fax

Practice location:
  • Phone: 515-967-6500
  • Fax:
Mailing address:
  • Phone: 614-905-7854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number128765
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: