Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 084732 | IA |
NPI | 1063031797 |
---|---|
Provider Name | Amanda C Paulson |
First Address | Solon, IA 52333-9712 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2020 |
Last Update Date | 13/04/2020 |