Individual
AMY ITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1952 E 7000 S, SALT LAKE CITY, UT 84121-6877
(801) 942-3311
(801) 495-5303
Mailing address
1221 S GEAR AVE, WEST BURLINGTON, IA 52655-1679
(319) 768-4124
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4168
IA
Other
Enumeration date
05/04/2010
Last updated
04/13/2020
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