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Individual

DR. JORDAN MICHAEL DEGRAZIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
610 EASTBURY DR., SUITE 3, IOWA CITY, IA 52245
(319) 887-6992
(319) 887-6983
Mailing address
610 EASTBURY DRIVE, SUITE 3, IOWA CITY, IA 52245
(319) 887-6992
(319) 887-6983

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06528
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0265678
IA
01
50709
BLUE CROSS & BLUE SHIELD
IA
Enumeration date
01/14/2006
Last updated
07/08/2007
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