Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 077433 | IA |
NPI | 1003284266 |
---|---|
Provider Name | Tonya M Epp |
First Address | Marion, IA 52302-3846 |
Second Address | Marion, IA 52302-3846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2015 |
Last Update Date | 08/09/2016 |