Individual
MRS. KRISTA LEE DYKSTRA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
143 N MAIN ST, GEORGE, IA 51237-0177
(712) 475-3990
Mailing address
PO BOX 177, GEORGE, IA 51237-0177
(712) 475-3990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IA06073
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166421
—
IA
01
—
22588
SIOUX VALLEY HEALTH PLAN
IA
01
—
41037
WELLMARK BCBS
IA
Enumeration date
02/02/2006
Last updated
07/08/2007
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