Individual
KOURTNE KAY SHANAHAN POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1310 TOWER LANE NE, CEDAR RAPIDS, IA 52402-7488
(319) 366-2518
(319) 366-5002
Mailing address
1310 TOWER LANE NE, CEDAR RAPIDS, IA 52402-7488
(319) 366-2518
(319) 366-5002
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05972
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58048
BLUE CROSS BLUE SHIELD
IA
Enumeration date
04/20/2007
Last updated
01/19/2016
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