Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 18802 | IA |
NPI | 1336151505 |
---|---|
Provider Name | Duane Verne Wilkins |
First Address | Pleasant Hill, IA 50327-7063 |
Second Address | Des Moines, IA 50316-2174 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |