Individual
ADAM THOMAS VANDERMOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2901 86TH ST, URBANDALE, IA 50322-4201
(515) 251-3880
Mailing address
2901 86TH ST, URBANDALE, IA 50322-4201
(515) 251-3880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005229
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005229
STATE LICENSE
IA
05
—
1134567657
—
IA
Enumeration date
06/06/2013
Last updated
01/29/2015
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