1891061826

Everything you always wanted to know about ANDREW ANN BETH LISW 1 PETEFISH ANN BETH but were afraid to ask.

ANDREW ANN BETH LISW 1 PETEFISH ANN BETH

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Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Last Name Provider Other Middle Name Provider Other First Name
ANDREW ANN BETH LISW 1 PETEFISH ANN BETH
Gender:
Female
Enumeration date:
2012-03-23
Last update date:
2017-12-07
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
1041C0700X Clinical IA 03010 Y

Phone Numbers

Type Number
Practice Location Address Telephone Number 6417523912
Mailing Address Fax Number 6417523639
Practice Location Address Fax Number 6417523639
Mailing Address Telephone Number 6415217126

Addresses

Type Address City State Postal Country
Mailing Address 2932 240TH ST MARSHALLTOWN IA 50158 IA
Practice Location Address 2932 240TH ST MARSHALLTOWN IA 50158 IA

Other NPI Records that share a phone number

NPI Name Address State City
1689707622 QUAKERDALE FAMILY SERVICES
Organization
2932 240TH ST IA MARSHALLTOWN
1710485057 KELLER, RYAN
Individual
2932 240TH ST IA MARSHALLTOWN
1780182113 EBERLINE, RONALD
Individual
2932 240TH ST IA MARSHALLTOWN
1790051332 RATH, ESTHER
Individual
1909 SUMMIT ST IA MARSHALLTOWN

Other NPI Records that share an address

NPI Name Address State City
1689707622 QUAKERDALE FAMILY SERVICES
Organization
2932 240TH ST IA MARSHALLTOWN
1710485057 KELLER, RYAN
Individual
2932 240TH ST IA MARSHALLTOWN
1780182113 EBERLINE, RONALD
Individual
2932 240TH ST IA MARSHALLTOWN