Individual
ANDREA KAYE DIETZENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
110 JEFFERSON ST, WEST UNION, IA 52175-1022
(563) 422-3817
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002140
IA
Other
Enumeration date
08/06/2010
Last updated
04/08/2015
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