Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 06676 | IA |
NPI | 1124000120 |
---|---|
Provider Name | Dr. Cory R Drees |
First Address | Indianola, IA 50125-1513 |
Second Address | Indianola, IA 50125-2421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 08/07/2007 |