Individual
AMY MARIE PONCELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 N 7TH ST, CHARITON, IA 50049-1210
(515) 250-6013
Mailing address
1200 N 7TH ST, CHARITON, IA 50049-1210
(515) 250-6013
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
079224
IA
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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