Individual
SAMUEL RICHARD JAMES DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
312 9TH ST SW, WAVERLY, IA 50677-2929
(319) 352-5644
Mailing address
906 1ST AVE NE, WAVERLY, IA 50677-2716
(319) 939-3810
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
092492
IA
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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