Magen Marie Lange, D.C.
Individual provider Active NPI Chiropractor · De Witt, IA
NPI 1376799247 · NPPES record last updated Aug 12, 2008
Key facts
- NPI
- 1376799247
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 007112 (IA)
- Practice address
- 602 12TH Street
De Witt, IA 52742-9998 - Phone
- (563) 659-8155
- Fax
- (563) 659-3520
- NPI assigned
- Aug 12, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007112 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kuethe Chiropractic | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 007112 | IA | Yes |
Addresses
Primary practice location
602 12TH Street
De Witt, IA 52742-9998
Mailing address
602 12TH Street
De Witt, IA 52742-9998
Phone (563) 659-8155
Other providers in De Witt, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.