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Individual

VINCENT MANDRACCHIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1801 HICKMAN RD, BROADLAWNS MEDICAL CENTER, DES MOINES, IA 50314-1505
(515) 282-2319
(515) 282-3234
Mailing address
1801 HICKMAN RD, BROADLAWNS MEDICAL CENTER, DES MOINES, IA 50314-1505
(515) 282-2319
(515) 282-3234

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000581
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1088146
IA
Enumeration date
09/14/2005
Last updated
12/22/2008
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