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Individual

MARK ANDREW GVIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
204 S 1ST ST, CARLISLE, IA 50047-7601
(515) 989-0097
(515) 989-9009
Mailing address
204 S 1ST ST, BOX 133, CARLISLE, IA 50047-7601
(515) 989-0097
(515) 989-9009

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05327
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1258681
IA
Enumeration date
02/28/2006
Last updated
10/04/2011
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