Healthcare Provider Details

I. General information

NPI: 1952554990
Provider Name (Legal Business Name): LAURA ANN INGWERSEN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 OKOBOJI AVE SUITE F
MILFORD IA
51351-1293
US

IV. Provider business mailing address

2207 OKOBOJI AVE SUITE F
MILFORD IA
51351-1293
US

V. Phone/Fax

Practice location:
  • Phone: 712-338-2225
  • Fax: 712-338-2578
Mailing address:
  • Phone: 712-338-2225
  • Fax: 712-338-2578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1528
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007145
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: