Individual
DR. JEANNE RENEE STAUDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
133 W MAIN AVE, ROCKFORD, IA 50468-7719
(641) 756-3740
(641) 756-3722
Mailing address
133 W MAIN AVE, P.O. BOX 575, ROCKFORD, IA 50468-7719
(641) 756-3740
(641) 756-3722
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05231
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1242305
—
IA
01
—
41891
BC/BS PROVIDER NUMBER
IA
01
—
P00070391
PALMETTO GBA PROV. NUMBER
IA
Enumeration date
06/09/2006
Last updated
07/30/2012
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