Individual
MR. JASON JOHN PUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1129 11TH ST SE, SUITE A, DYERSVILLE, IA 52040
(563) 875-8615
(563) 875-8722
Mailing address
1129 11TH ST SE, SUITE A, DYERSVILLE, IA 52040
(563) 875-8615
(563) 875-8722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03051
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1209163
—
IA
01
—
35223
BLUE SHIELD PROVIDER #
IA
Enumeration date
05/23/2006
Last updated
11/09/2016
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