Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1083993612 |
---|---|
Provider Name | Dianne Vogel |
First Address | Independence, IA 50644-9707 |
Second Address | Independence, IA 50644-9707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2011 |
Last Update Date | 13/08/2011 |