Individual
DR. BONNIE L BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
306 11TH ST, DEWITT, IA 52742-1404
(563) 659-1667
(563) 221-9218
Mailing address
306 11TH ST, DEWITT, IA 52742-1404
(563) 659-1667
(563) 221-9218
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
AO5310
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00969
BLUE CROSS BLUE SHIELD
IA
05
—
1009696
—
IA
01
—
42-1502650
TAX ID
IA
01
—
7567
MIDLAND'S CHOICE
—
Enumeration date
01/17/2006
Last updated
01/20/2011
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