Individual
LONNY L. WILKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2415 18TH ST, SUITE 107, BETTENDORF, IA 52722-0202
(563) 355-0010
(563) 355-2905
Mailing address
2416 18TH ST, SUITE 107, BETTENDORF, IA 52722-4832
(563) 355-0010
(563) 355-2905
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04722
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169003
—
IA
01
—
16900
BCBS
IA
Enumeration date
09/07/2006
Last updated
09/01/2011
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