Individual
MYLAH ZALDIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 JEFFERSON ST, PELLA, IA 50219-1255
(641) 628-6623
(641) 621-2223
Mailing address
404 JEFFERSON ST, PELLA, IA 50219-1257
(641) 628-6623
(641) 621-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
072792
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072792
IOWA LICENSE
IA
Enumeration date
01/18/2018
Last updated
03/17/2018
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