Healthcare Provider Details

I. General information

NPI: 1962474783
Provider Name (Legal Business Name): ARDEN BURDETTE KEUNE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 US HIGHWAY 71
SIOUX RAPIDS IA
50585-2061
US

IV. Provider business mailing address

PO BOX 151
SIOUX RAPIDS IA
50585-0151
US

V. Phone/Fax

Practice location:
  • Phone: 712-283-2112
  • Fax: 712-283-2112
Mailing address:
  • Phone: 712-283-2112
  • Fax: 712-283-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberA05464
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: