MEDICARE: DR. AUSTIN DAVID DEHOOGH D.C.

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
1	111N00000X	Chiropractor	1738	NM
2	111N00000X	Chiropractor	093290	IA

General Provider Information

NPI Number	:	1417286360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUSTIN DAVID DEHOOGH D.C.

Provider Business Mailing Address
First Line	:	1239 73RD ST STE K
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-1343
Country	:	US
Telephone Number	:	515-274-4444
Fax Number	:	515-274-2473

Provider Business Practice Location Address
First Line	:	1239 73RD ST STE K
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-1339
Country	:	US
Telephone Number	:	515-274-4444
Fax Number	:	515-274-2473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2009
Last Update Date	:	05/23/2019

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