Individual
DIANE E DEWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1507 N 1ST ST, INDIANOLA, IA 50125-3703
(515) 961-7435
(515) 961-7436
Mailing address
1507 N 1ST ST, INDIANOLA, IA 50125-3703
(515) 961-7435
(515) 961-7436
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01074
IA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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