Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | A5663 | IA |
NPI | 1295727394 |
---|---|
Provider Name | Dr. Stephanie J. Veldman |
First Address | Spirit Lake, IA 51360-1061 |
Second Address | Spirit Lake, IA 51360-1061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1090308 | (05) | IA |