Healthcare Provider Details

I. General information

NPI: 1235203704
Provider Name (Legal Business Name): DENNIS F. VONNAHME D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 N MAIN ST
POCAHONTAS IA
50574-2026
US

IV. Provider business mailing address

118 N MAIN ST PO BOX 194
POCAHONTAS IA
50574-2026
US

V. Phone/Fax

Practice location:
  • Phone: 712-335-4900
  • Fax: 712-335-4949
Mailing address:
  • Phone: 712-335-4900
  • Fax: 712-335-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberA05885
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: