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Organization
MARK A. HAVERTAPE P.C.
Active
Organization
MARK A. HAVERTAPE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALLAN HAVERTAPE DC (PRESIDENT)
(319) 364-6387
Entity
Organization
Contact information
Practice address
3804 1ST AVE NE, CEDAR RAPIDS, IA 52402-5603
(319) 364-6387
Mailing address
3804 1ST AVE NE, CEDAR RAPIDS, IA 52402-5603
(319) 364-6387
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05832
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125369
—
IA
Enumeration date
09/20/2006
Last updated
08/22/2020
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