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:
2012-03-23
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
Mailing Address Telephone Number 6417523912
Practice Location Address Telephone Number 6417523912
Mailing Address Fax Number 6417523639
Practice Location Address Fax Number 6417523639

Addresses

Type Address City State Postal Country
Mailing Address 1909 SUMMIT ST MARSHALLTOWN IA 50158 IA
Practice Location Address 1909 SUMMIT ST MARSHALLTOWN IA 50158 IA

Other NPI Records that share a phone number

NPI Name Address State City
1790051332 RATH, ESTHER
Individual
1909 SUMMIT ST IA MARSHALLTOWN

Other NPI Records that share an address

NPI Name Address State City
1790051332 RATH, ESTHER
Individual
1909 SUMMIT ST IA MARSHALLTOWN