Healthcare Provider Details

I. General information

NPI: 1770533382
Provider Name (Legal Business Name): MARITA A TURNER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 1/2 E STREET
SERGEANT BLUFF IA
51054-0908
US

IV. Provider business mailing address

PO BOX 908 401 1/2 E STREET
SERGEANT BLUFF IA
51054-0908
US

V. Phone/Fax

Practice location:
  • Phone: 712-943-1550
  • Fax:
Mailing address:
  • Phone: 712-943-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number04863
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: