Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000833 | IA |
Y | 222Z00000X | Podiatrist | 000833 | IA |
N | 213ES0131X | Foot Surgery | 000833 | IA |
NPI | 1063666089 |
---|---|
Provider Name | Ms. Sarah Elizabeth Polk |
First Address | Iowa City, IA 52242-1009 |
Second Address | Coralville, IA 52241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2008 |
Last Update Date | 28/08/2019 |