Individual
ANDREW JEDLICKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
1421 27TH ST, DES MOINES, IA 50311-3020
(563) 219-2200
Mailing address
1421 27TH ST, DES MOINES, IA 50311-3020
(563) 219-2200
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
000918
IA
207PS0010X
Sports Medicine (Emergency Medicine) Physician
1926-39
WI
2255A2300X
Athletic Trainer
Primary
—
IA
Other
Enumeration date
06/08/2016
Last updated
08/02/2022
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