Individual
DEBRA ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 BROOKRIDGE CIR, ATLANTIC, IA 50022-2304
(615) 896-6400
Mailing address
PO BOX 244, HARLAN, IA 51537-0244
(712) 235-2107
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00511
IA
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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