Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 005450 | IA |
NPI | 1376860817 |
---|---|
Provider Name | Mrs. Joy Gerri Shatek |
First Address | New Hampton, IA 50659-2138 |
Second Address | New Hampton, IA 50659-2138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 23/04/2010 |