Madonna Susan Diez P.A.-C

NPI 1619153608 - Physician Assistant - 363A00000X

NPI Details
NPI 1619153608
Gender Female
Enumeration Date 01/21/2008
Last Updated 10/27/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
1765 LININGER LN
NORTH LIBERTY IA, 52317-2316, US
Phone (319) 665-3073
Fax
Business Location
1865 LININGER LANE
MERCY CARE URGENT CARE NORTH LIBERTY
NORTH LIBERTY IA, 52317-9575, US
Phone (319) 665-3073
Fax (319) 626-5687
Toxanomy
Taxonomy Code 363A00000X
License State Georgia
License Number 005082
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According to our database, Madonna Susan Diez P.A.-C NPI is 1619153608, taxonomy code is 363A00000X and license number is 005082, license state is located at Georgia. Madonna Susan Diez P.A.-C physically located at 1765 Lininger Ln, North Liberty IA, 52317-2316. NPI Number Madonna Susan Diez P.A.-C has the Individual type.

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1619153608 NPI number is provided on an as is basis without warranty of any kind. 1619153608 is maintained by the National Plan & Provider Enumeration System. The contents of Madonna Susan Diez P.A.-C are for informational purposes only.