Healthcare Provider Details

I. General information

NPI: 1881690220
Provider Name (Legal Business Name): LANCE GREGORY STROVERS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 6TH AVE
GRINNELL IA
50112-1955
US

IV. Provider business mailing address

415 6TH AVE
GRINNELL IA
50112-1955
US

V. Phone/Fax

Practice location:
  • Phone: 641-236-9355
  • Fax: 641-236-9357
Mailing address:
  • Phone: 641-236-9355
  • Fax: 641-236-9357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06549
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: