Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 03281 | IA |
NPI | 1023664018 |
---|---|
Provider Name | Teresa Louise Schroeder |
First Address | Waukee, IA 50263-8742 |
Second Address | Des Moines, IA 50316-1717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2019 |
Last Update Date | 14/08/2019 |