Healthcare Provider Details

I. General information

NPI: 1659070845
Provider Name (Legal Business Name): DALLAS MENKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 FIVE MILE DR
BOONE IA
50036-7518
US

IV. Provider business mailing address

1305 FIVE MILE DR
BOONE IA
50036-7518
US

V. Phone/Fax

Practice location:
  • Phone: 515-432-9525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number119241
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: