Individual
DR. LYLE D NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
310 1ST STREET, SERGEANT BLUFF, IA 51054-0006
(712) 943-1589
(712) 943-1591
Mailing address
PO BOX 6, SERGEANT BLUFF, IA 51054-0006
(712) 943-1589
(712) 943-1591
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05757
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1107557
—
IA
Enumeration date
09/12/2005
Last updated
07/09/2007
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