Individual
DANIEL JACOB NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
812 UNIVERSITY ST, PELLA, IA 50219-1902
(877) 462-3687
Mailing address
5412 NW 92ND ST, JOHNSTON, IA 50131-1795
(515) 276-9166
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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