Healthcare Provider Details

I. General information

NPI: 1720055080
Provider Name (Legal Business Name): JAMEY J ERRTHUM DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 C AVE
KALONA IA
52247-9742
US

IV. Provider business mailing address

PO BOX 356
KALONA IA
52247-0356
US

V. Phone/Fax

Practice location:
  • Phone: 319-656-2085
  • Fax: 319-656-2085
Mailing address:
  • Phone: 319-656-2085
  • Fax: 319-656-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberA06080
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: