Individual
BRUCE A EWOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1134 MAIN ST., PO BOX 808, HULL, IA 51239
(712) 439-2936
Mailing address
PO BOX 808, HULL, IA 51239-0808
(712) 439-2936
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5116
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231944
—
IA
Enumeration date
02/15/2006
Last updated
05/24/2019
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