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NPI Code Detail

MEDICARE: DR. JOSHUA BLAKE HANISCH D.C, B.S.

MEDICARE:  DR. JOSHUA BLAKE HANISCH  D.C, B.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor007433IA

General Provider Information

NPI Number : 1295020410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA BLAKE HANISCH D.C, B.S.
Provider Business Mailing Address
First Line : 4539 DOUGLAS AVE
Second Line : SUITE A
City : DES MOINES
State : IA
Zip : 50310-2711
Country : US
Telephone Number : 515-276-2263
Fax Number : 515-251-2969
Provider Business Practice Location Address
First Line : 4539 DOUGLAS AVE
Second Line : SUITE A
City : DES MOINES
State : IA
Zip : 50310-2711
Country : US
Telephone Number : 515-276-2263
Fax Number : 515-251-2969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 06/15/2011

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Directions to “ DR. JOSHUA BLAKE HANISCH D.C, B.S.” Practice Location

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