Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 00494 | IA |
NPI | 1003080987 |
---|---|
Provider Name | Rosemary Marie Sieren |
First Address | West Des Moines, IA 50266-1305 |
Second Address | West Des Moines, IA 50266-1305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 22/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0665190 | (05) | IA |